Rimegepant: acute treatment for migraine headaches

2021 ◽  
Author(s):  
Golden L Peters ◽  
Erin K Hennessey
Keyword(s):  
Migraine Headache ◽  
Acute Treatment ◽  
Treatment Options ◽  
Migraine Treatment ◽  
Acute Migraine ◽  
The Past ◽  
Vasoactive Peptides ◽  
Migraine Headaches ◽  
Calcitonin Gene ◽  
Acute Migraine Treatment

Migraine headache treatment is quickly evolving. There have been three new acute migraine treatment options (i.e., lasmiditan, rimegepant, ubrogepant) and four new preventive migraine treatment options (i.e., erenumab, fremanezumab, galcanezumab, eptinezumab) released in the past 3 years. The new migraine treatments are focusing on pathways within the newly, better understood neurovascular hypothesis that further describes the pathophysiology of migraine headaches in more detail than before. The discovery of vasoactive peptides, such as calcitonin gene-related peptide, has led to the development of many of these migraine agents. Rimegepant is one of these newly approved agents for acute migraine treatment in adults with or without aura. Rimegepant has been found to decrease pain and symptoms associated with migraine attacks and is generally well-tolerated.

scholarly journals Effect of Calcitonin Gene-Related Peptide Receptor Antagonists on Migraine Treatment: A Meta-Analysis

2021 ◽  
Author(s):  
Jiyoung Kim ◽  
Kyoungjune Pak ◽  
Gha-Hyun Lee ◽  
Jae Wook Cho ◽  
Hyun-Woo kim
Keyword(s):  
Meta Analysis ◽  
Calcitonin Gene Related Peptide ◽  
Migraine Treatment ◽  
Acute Migraine ◽  
Cgrp Receptor ◽  
Receptor Antagonists ◽  
Related Peptide ◽  
Calcitonin Gene ◽  
Cgrp Receptor Antagonists ◽  
Acute Migraine Treatment

Abstract Background: The pathophysiology of migraine has been researched incessantly, and it has been suggested that calcitonin gene-related peptide (CGRP) is associated with migraine attacks. CGRP receptor blockers are attracting attention for migraine prevention and treatment of acute episodes, and CGRP receptor antagonists have been shown to be effective in treating acute migraine headaches. This meta-analysis aimed to assess the effect of available CGRP receptor antagonists, focusing on their therapeutic doses for acute migraine treatment.Methods: We performed a systematic search of MEDLINE (from inception to March 2021) and EMBASE (from inception to March 2021) for English publications using the keywords “migraine” and “Calcitonin gene-related peptide,” limited to human studies.Results: Five studies that focused on examining the effects of CGRP receptor antagonists on acute migraine treatment met the eligibility criteria for this meta-analysis. The pooled analysis demonstrated that the CGRP receptor antagonist improved freedom from pain (OR=2.066, 95% confidence interval [CI] 1.766–2.418, I2=0%), absence of bothersome symptoms (OR=1.606, 95% CI=1.408–1.830, I2=0%), pain relief (OR=1.791, 95% CI=1.598–2.008, I2=0%), and freedom from nausea (OR=1.361, 95% CI=1.196–1.548, I2=0%), significantly more than the placebo. Conclusions: CGRP receptor antagonists are effective for acute migraine treatment and are expected to be used clinically as emerging therapeutic agents.

What efficacy measures are clinically relevant and should be used in Cochrane Reviews of acute migraine trials? A viewpoint

Cephalalgia ◽  
2014 ◽  
Vol 35 (5) ◽  
pp. 457-459 ◽  
Author(s):  
Peer Tfelt-Hansen
Keyword(s):  
Clinical Relevance ◽  
Migraine Headache ◽  
Cochrane Review ◽  
Migraine Treatment ◽  
Acute Migraine ◽  
High Quality ◽  
Cochrane Reviews ◽  
Headache Relief ◽  
Efficacy Measures ◽  
Acute Migraine Treatment

Background Cochrane Reviews are methodologically of high quality but the clinical relevance of analysed efficacy measures (EMs) should also be assessed. Methods The clinical relevance of EMs used in one systematic Cochrane review of oral zolmitriptan for migraine headache was evaluated. Results The following EMs were used: pain free at two hours (30%), headache relief at two hours (60%), sustained pain free for 24 hours (19%) and sustained headache relief for 24 hours (39%). These EMs were also used in four other Cochrane reviews of acute migraine treatment. Of these EMs sustained headache relief for 24 h is not judged clinically relevant. Conclusion Pain free and sustained pain free are clinically relevant, but the responses are rather low, demonstrating that there is a need for improvement of acute drug treatment in migraine.

scholarly journals Targeted Review: Medications for Acute Migraine Treatment

2013 ◽  
Vol 40 (S3) ◽  
pp. S10-S32 ◽  
Author(s):  
Irene Worthington ◽  
Tamara Pringsheim ◽  
Marek J. Gawel ◽  
Jonathan Gladstone ◽  
Paul Cooper ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Acute Treatment ◽  
Randomized Clinical Trials ◽  
Migraine Treatment ◽  
Acute Migraine ◽  
Double Blind ◽  
Strong Recommendation ◽  
Combination Analgesics ◽  
Quality Evidence ◽  
Acute Migraine Treatment

ABSTRACT:Objective:To assess the evidence base for drugs used for acute treatment of episodic migraine (headache on < 14 days a month) in Canada.Methods:A detailed search strategy was employed to find relevant published clinical trials of drugs used in Canada for the acute treatment of migraine in adults. Primarily meta-analyses and systematic reviews were included. Where these were not available for a drug or were out of date, individual clinical trial reports were utilized. Only double-blind randomized clinical trials with placebo or active drug controls were included in the analysis. Recommendations and levels of evidence were graded according to the principles of the Grading of Recommendations Assessment, Development and Evaluation (GRADE) Working Group, using a consensus group.Results:Eighteen acute migraine medications and two adjunctive medications were evaluated. Twelve acute medications received a strong recommendation with supporting high quality evidence for use in acute migraine therapy (almotriptan, eletriptan, frovatriptan, naratriptan, rizatriptan, sumatriptan, zolmitriptan, ASA, ibuprofen, naproxen sodium, diclofenac potassium, and acetaminophen). Four acute medications received a weak recommendation for use with low or moderate quality evidence (dihydroergotamine, ergotamine, codeine-containing combination analgesics, and tramadol-containing combination analgesics). Three of these medications were NOT recommended for routine use (ergotamine, and codeine- and tramadol-containing medications), and strong recommendations were made to avoid use of butorphanol and butalbital-containing medications. Both metoclopramide and domperidone received a strong recommendation for use with acute migraine attack medications where necessary.Conclusion:Our targeted review formulated recommendations for the available acute medications for migraine treatment according to the GRADE method. This should be helpful for practitioners who prescribe medications for acute migraine treatment.

scholarly journals The Public’s Perception of Interventions for Migraine Headache Disorders: A Crowdsourcing Population-Based Study

2019 ◽  
Vol 1 (2) ◽  
Author(s):  
Orr Shauly ◽  
Daniel J Gould ◽  
Ketan M Patel
Keyword(s):  
Migraine Headache ◽  
Treatment Options ◽  
The United States ◽  
Cost Of Care ◽  
Adverse Outcomes ◽  
Amazon Mechanical Turk ◽  
Cross Sectional ◽  
Economic Productivity ◽  
Migraine Headaches ◽  
Patient Reported

Abstract Background Migraine disorders are a leading cause of morbidity and decreased economic productivity in the United States among both men and women. As such, it is important to consider patient opinions, and have an accurate representation of the burden and sentiment toward currently available interventions among those suffering from migraines. Objectives The aim of the study was to assess patient options regarding adverse outcomes of the various treatment options available for migraine headaches. Methods A prospective cross-sectional study of volunteers recruited through an internet crowdsourcing service, Amazon Mechanical Turk©, was conducted. Surveys were administered to collect patient-reported opinions regarding adverse outcomes of both surgical and nonsurgical treatment options for migraine headaches. Results The prevalence of migraine headache across all study participants was 15.6% and varied slightly across participant demographics. Individuals ages 35–44 (2.73 migraines per month) experienced the fewest migraine and with the lowest severity. Those individuals ages 45+ experienced the most severe headaches (Visual Analog Scale = 44.23 mm). Additionally, the greatest migraine frequency and severity existed among those households with yearly income of $75,000–$100,000. The lowest injection therapy utility scores were obtained for adverse outcomes of hematoma (47.60 mm) and vertigo (54.40 mm). Conclusions Migraine headaches remains a significant problem among the US population, with an overall prevalence of 15.6% (approximately 50 million Americans). Additionally, physicians interesting in offering minimally invasive or surgical treatment for migraine headaches should focus on mitigating patient fears regarding clinical outcomes and cost of care.

Targeted Review: Medications for Acute Migraine Treatment

2013 ◽  
Vol 40 (S3) ◽  
pp. S10-S32 ◽  
Author(s):  
Irene Worthington ◽  
Tamara Pringsheim ◽  
Marek J. Gawel ◽  
Jonathan Gladstone ◽  
Paul Cooper ◽  
...  
Keyword(s):  
Migraine Treatment ◽  
Acute Migraine ◽  
Acute Migraine Treatment

New targets in acute migraine treatment

2006 ◽  
Vol 1 (2) ◽  
pp. 171-177 ◽  
Author(s):  
Peter J Goadsby
Keyword(s):  
Migraine Treatment ◽  
Acute Migraine ◽  
New Targets ◽  
Acute Migraine Treatment

Early dosing and efficacy of triptans in acute migraine treatment: the TEMPO study

Cephalalgia ◽  
2012 ◽  
Vol 32 (3) ◽  
pp. 226-235 ◽  
Author(s):  
M Lantéri-Minet ◽  
G Mick ◽  
B Allaf
Keyword(s):  
Migraine Treatment ◽  
Acute Migraine ◽  
Acute Migraine Treatment
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