Rimegepant

(Nurtec ODT®)

Rimegepant

Drug updated on 10/28/2024

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.

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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% 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 odds ratio (OR) of 1.29 (95% CI (confidence interval) [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.

Product Monograph / Prescribing Information

Document TitleYearSource
Nurtec ODT (rimegepant) Prescribing Information.2023Pfizer Inc., New York, NY

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 trials2024The Journal of Headache and Pain
Clinical efficacy and safety of rimegepant in the treatment of migraine: a meta-analysis of randomized controlled trials2023Frontiers in Neurology
Safety and tolerability of monoclonal antibodies targeting the CGRP pathway and gepants in migraine prevention: A systematic review and network meta-analysis2023Cephalalgia
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 literature2023Cephalalgia
Rimegepant, Ubrogepant, and Lasmiditan in the Acute Treatment of Migraine Examining the Benefit-Risk Profile Using Number Needed to Treat/Harm2022The Clinical Journal of Pain
Relative efficacy of lasmiditan versus rimegepant and ubrogepant as acute treatments for migraine: network meta-analysis findings2022The Journal of Headache and Pain
Comparative efficacy and safety of rimegepant, ubrogepant, and lasmiditan for acute treatment of migraine: a network meta-analysis2022Expert Review of Pharmacoeconomics & Outcomes Research
Comparison of New Pharmacologic Agents With Triptans for Treatment of Migraine: A Systematic Review and Meta-analysis2021JAMA Network Open
Ditans vs Gepants: A Systematic Review and Indirect Network Meta-Analysis for Comparative Analysis of Efficacy and Safety2021Neurology India
Gepants for abortive treatment of migraine: A network meta-analysis2020 Brain and Behavior
Efficacy and Safety of Rimegepant for the Acute Treatment of Migraine: Evidence From Randomized Controlled Trials2019Frontiers in Pharmacology

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