Rimegepant

(Nurtec ODT®)

Rimegepant

Drug updated on 5/17/2024

Dosage FormTablet (oral; 75 mg)
Drug ClassCalcitonin gene-related peptide receptor antagonists
Ongoing and
Completed Studies
ClinicalTrials.gov

Indication

  • Indicated for the acute treatment of migraine with or without aura in adults.
  • Indicated for the treatment of episodic migraine in adults.

Summary
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  • Rimegepant (Nurtec ODT) is indicated for the acute treatment of migraine with or without aura in adults, as well as for the treatment of episodic migraine in adults.
  • A total of 14 studies were reviewed to gather insights on rimegepant's efficacy and safety profile compared to other treatments such as lasmiditan, ubrogepant, zavegepant, and various triptans.
  • The studies showed that rimegepant has a favorable efficacy profile for achieving pain relief within 2 hours when compared to ubrogepant (25 mg and 50 mg) and zavegepant. It also demonstrates a higher probability of achieving freedom from photophobia within 2 hours compared to ubrogepant (25 mg) and lasmiditan (50 mg).
  • In direct comparisons with triptans, rimegepant was generally found less effective regarding pain freedom at two hours but had a better safety profile than most triptans.
  • Rimegepant displays a relatively favorable safety profile; its risk level concerning adverse events is comparable to placebo. However, it poses slightly higher risks than placebo but lower incidences than triptans regarding primary outcomes like any adverse events or treatment-related ones.
  • Specific adverse drug reactions associated with rimegepant correlated with sociodemographic factors including dosage effects on muscle strain & liver function along with Body Mass Index (BMI).
  • Studies included predominantly female participants, reflecting the high prevalence rate among women. Significant correlations were found between specific side-effect incidence rates & clinical characteristics (e.g., age), suggesting certain subgroups may be more susceptible to these effects.
  • The impact of sociodemographic factors on drug efficacy & tolerability indicates the importance of personalized approaches considering individual patient history, risk factors, and potentiality for adverse events.

Product Monograph / Prescribing Information

Document TitleYearSource
Nurtec ODT (rimegepant) Prescribing Information.2023Biohaven Pharmaceuticals Inc., New Haven, CT

Systematic Reviews / Meta-Analyses

Document TitleYearSource
Comparison of effectiveness and safety of lasmiditan and CGRP-antagonists for the acute treatment of migraine in adults: systematic review and network meta-analysis of randomised trials.2024The Journal of Headache and Pain
Ubrogepant and rimegepant: systematic review, meta-analysis, and meta-regression of clinical studies.2023Expert Opinion on Drug Safety
Efficacy, safety and indirect comparisons of lasmiditan, rimegepant, and ubrogepant for the acute treatment of migraine: A systematic review and network meta-analysis of the literature.2023Cephalalgia
Clinical efficacy and safety of rimegepant in the treatment of migraine: a meta-analysis of randomized controlled trials.2023Frontiers in Neurology
Evaluating the efficacy of CGRP mAbs and gepants for the preventive treatment of migraine: A systematic review and network meta-analysis of phase 3 randomised controlled trials.2023Cephalalgia
Relative efficacy of lasmiditan versus rimegepant and ubrogepant as acute treatments for migraine: network meta-analysis findings.2022The Journal of Headache and Pain
Safety evaluation of oral calcitonin-gene–related peptide receptor antagonists in patients with acute migraine: a systematic review and meta-analysis.2022European Journal of Clinical Pharmacology
Rimegepant, ubrogepant, and lasmiditan in the acute treatment of migraine examining the benefit-risk profile using number needed to treat/harm.2022The Clinical Journal of Pain
Comparative efficacy and safety of rimegepant, ubrogepant, and lasmiditan for acute treatment of migraine: a network meta-analysis.2021Expert Review of Pharmacoeconomics & Outcomes Research
Comparison of new pharmacologic agents with triptans for treatment of migraine.2021JAMA Network Open
Comparative efficacy of oral calcitonin‑gene–related peptide antagonists for the treatment of acute migraine: updated meta‑analysis.2021Clinical Drug Investigation
Ditans vs gepants: a systematic review and indirect network meta-analysis for comparative analysis of efficacy and safety.2021Neurology India
Novel therapies in acute migraine management: small-molecule calcitonin gene-receptor antagonists and serotonin 1F receptor agonist.2020Annals of Pharmacotherapy
Efficacy and safety of rimegepant for the acute treatment of migraine: evidence from randomized controlled trials.2020Frontiers in Pharmacology

Clinical Practice Guidelines