CGRP receptor antagonist has shown efficacy for the treatment and prevention of migraine

In a clinical trial, the CGRP receptor antagonist drug rimegepant reduced the number of headache days per month and outperformed placebo. For half of those taking it, the number of headache days decreased by 50% or more.

For the first time, an oral drug from the CGRP group, rimegepant, has shown effectiveness in both the relief and prevention of migraines. This was stated to the MedScape portal by co-author of the study, Professor Peter Godsby from King’s College London (UK) and the University of California (USA).

According to a publication in The Lancet, the phase 2/3 clinical trial took place at 92 American centers. The efficacy analysis included 695 participants with episodic and chronic migraine. They received rimegepant or placebo for 12 weeks.

In the last weeks of the study, the number of headache days per month in the rimegepant group decreased by an average of 4.3 days, while in the placebo group it decreased by 3.5 days. Additionally, during the same period, a reduction in the number of days with headaches per month was assessed by 50% – this figure was achieved in 49% of participants in the first group and in 41% in the second.

Tolerability of the drug was similar to placebo, a safety analysis of 741 participants showed. Adverse reactions were reported by 36% of subjects in each group. Adverse reactions led to trial discontinuation in 2% of patients in the rimegepant group and 1% in the placebo group.

US Food and Drug Administration (The FDA has accepted a marketing authorization application for rimegepant for the prevention of migraine. A final decision is expected in the second quarter of 2021.

The first oral CGRP receptor antagonist approved in the United States for the treatment of migraine attacks was ubrogepant. In February 2020, rimegepant was also approved for this indication in the form of orally dispersible tablets. As the FDA has indicated, both products are not intended for migraine prevention.

Erenumab, another CGRP receptor antagonist, was the first migraine prevention drug ever approved by the FDA. In 2020, it received registration in Russia.

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