AHS 2022 | Open-label extension study of rimegepant for acute and preventive migraine treatment

Richard Lipton, MD, Albert Einstein College of Medicine, New York, NY, discusses an open-label extension study (NCT03732638) of rimegepant for preventive and acute migraine treatment. Traditionally in migraine therapy, acute treatments are used during the attack to reduce pain and restore function, whereas preventive treatments are used to reduce the frequency and/or severity of migraine attacks. A valuable attribute of the gepants class of drug is that they function well as both acute and preventive treatments. During the rimegepant long-term safety study, patients who used the drug acutely demonstrated a reduction in headache frequency over the year, leading to the study of rimegepant as a preventive treatment. The recent open-label extension study provided insights into how patients use rimegepant when available for acute and preventive treatment. Results showed that when patients were given unlimited access to rimegepant, they used it preventively as instructed and, on average less than once a month as an acute treatment. Monthly headache days declined throughout the study, and no safety concerns were observed. These results support the convenience of having a single drug that can be used in both settings. Rimegepant remains the only FDA-approved drug for acute and preventive treatment of migraine. This interview took place during the 2022 American Headache Society (AHS) Annual Scientific Meeting in Denver, CO.