Rimegepant orally disintegrating tablets in the acute treatment of migraine: a profile of their use
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ADIS DRUG Q&A
Rimegepant orally disintegrating tablets in the acute treatment of migraine: a profile of their use Esther S. Kim1 · Katherine A. Lyseng‑Williamson1 Published online: 30 October 2020 © Springer Nature Switzerland AG 2020
Abstract Rimegepant orally disintegrating tablets (ODT) for sublingual or oral use (Nurtec™ ODT) are a valuable option for the acute treatment of migraine ± aura in adults, especially those with contraindications, treatment failure, or tolerability issues with triptans. Rimegepant is a calcitonin gene-related peptide (CGRP) receptor antagonist, and is the first, and currently only, drug in this class available as an ODT formulation in the USA. A single sublingual dose of rimegepant ODT 75 mg provided freedom from pain, freedom from the most bothersome migraine symptoms (e.g., nausea, phonophobia, photophobia), and freedom from functional disability at 2-h post dose relative to placebo in adults with a migraine attack with pain of moderate or severe intensity ± aura. Beneficial effects on migraine were provided as early as 1-h post dose, and were sustained for 2–48 h. Rimegepant ODT was well tolerated, with a tolerability profile similar to that of placebo, with no reports of serious, cardiovascular, or hepatic adverse events in patients with migraine.
Adis evaluation of rimegepant ODT in the acute treatment of migraine ± aura in adults Convenient sublingual or oral administration up to once every 24-h period as required for the acute treatment of migraine ± aura Provides rapid and sustained freedom from pain and bothersome migraine symptoms, and restores normal functional ability Very well tolerated, with a lack of serious adverse events
Enhanced material For this Adis Drug Q&A can be found at https://doi.org/10.6084/m9.figshare.13078187. * Katherine A. Lyseng‑Williamson [email protected] 1
Springer Nature, Private Bag 65901, Mairangi Bay, Auckland 0754, New Zealand
What is the rationale for developing rimegepant ODT to treat migraine? Migraine typically manifests as recurrent attacks of unilateral and pulsatile headache pain of moderate to severe intensity that last 4–72 h, are aggravated by routine physical activity, are associated with nausea, photophobia, and/ or phonophobia, and, in about one-third of patients, are preceded or accompanied by aura (transient focal neurological symptoms) [1, 2]. Globally, migraine is one of the top five causes of long-term disability [3], has a peak prevalence in individuals aged 25–55 years, and affects about three times more women than men (1-year prevalence 18% vs 6%) [2]. Although a number of migraine-specific medications (triptans and dihydroergotamine) and non-specific medications (e.g. NSAIDs, non-opioid and opioid analgesics, and antiemetics) are available for the acute treatment of migraine [2], many of these options are limited by inadequate efficacy, poor tolerability, and a lack of patient adherence to their recommended use [4]. In the case of triptans, which have been the mainstay of acute treatment of migraine since the
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