Summary

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• This summary is based on the review of 11 systematic review(s)/meta-analysis(es). ^[1-11]
• Rimegepant (75 mg) provided significant pain relief within 2 hours compared to placebo, with an odds ratio (OR) of 1.84 (95% confidence interval (CI) [1.55, 2.18], P < 0.00001). Similar efficacy was observed when compared to other treatments, though lasmiditan showed slightly higher efficacy in some comparisons.
• Rimegepant demonstrated a favorable outcome in sustained pain relief over 24 hours, outperforming treatments such as zavegepant and ubrogepant (Number Needed to Treat (NNT) = 5, 95% credible interval (CrI) [4, 7]).
• Rimegepant was significantly effective in achieving freedom from the most bothersome symptoms at 2 hours (P < 0.001), similar to the efficacy observed with higher doses of ubrogepant and lasmiditan.
• Rimegepant (75 mg) showed no significant increase in overall adverse events compared to placebo, with an OR of 1.29 (95% CI [0.99, 1.67], P = 0.06). Lasmiditan, by comparison, had higher incidences of adverse effects such as dizziness, somnolence, and fatigue.
• Rimegepant demonstrated lower rates of somnolence and dizziness compared to higher doses of lasmiditan. In addition, anti-Calcitonin Gene-Related Peptide (CGRP) monoclonal antibodies and gepants, including rimegepant, were found to be safe and well-tolerated, with no significant differences in serious adverse events compared to placebo.
• The Number Needed to Harm (NNH) for nausea with rimegepant was higher than lasmiditan, indicating a lower incidence of this adverse effect for rimegepant.
• The majority of participants in the studies were women (over 80%), with a mean age range of 36 to 45.7 years. The studies focused on patients with episodic migraines, chronic migraines, and migraines with or without aura, demonstrating rimegepant's significant efficacy and safety for the acute treatment of episodic migraine patients.