Long-Term Preventive and Acute Treatment of Migraine With Rimegepant Improves Health Related Quality of Life
Jelena Pavlovic1, Ira Turner2, Paul Winner3, Richard Lipton1, Gilbert L'Italien4, Christopher Jensen4, Alexandra Thiry4, Lisa Kamen4, Robert Croop4
1Albert Einstein College of Medicine, 2Island Neurological Associates, PC, 3Palm Beach Headache Ctr, 4Biohaven Pharmaceuticals
Objective:

Assess the effects of rimegepant on quality of life (QoL) over 1-year of open-label treatment in which rimegepant was used for both preventive and acute treatment for migraine.

Background:

Rimegepant is an orally administered small molecule CGRP receptor antagonist for the acute and preventive treatment of migraine.

Design/Methods:

This open-label extension phase of a 12-week, phase 2/3, randomized, double-blind, placebo-controlled study (NCT03732638) enrolled adults aged ≥18 years with a history of 4-18 moderate to severe monthly migraine attacks. Subjects completing 12 weeks of double-blind treatment with rimegepant 75 mg or placebo every other day could continue with open-label treatment with rimegepant 75 mg for 52 weeks of preventive treatment. On nonscheduled dosing days, subjects could take open-label rimegepant 75 mg as needed up to once per day for acute treatment of migraine. The effects of rimegepant on QoL were measured using Migraine-Specific Quality-of-Life Questionnaire v 2.1 (MSQ) scores on the role restrictive (RR), role preventative (RP), and emotional function (EF) domains. Changes from baseline in MSQ domain scores were assessed at Weeks 12 and 52 of the open-label phase (ie, overall study Weeks 24 and 64). Higher MSQ scores indicated better quality of life.

Results:

Respective mean (SD) baseline MSQ scores for the RR, RP, and EF domains were 51.0 (18.70), 65.2 (21.01), and 57.7 (27.23). At Week 12 (n=536) mean (SD) changes from baseline in RR, RP, and EF, respectively, were 28.4 (22.71), 21.8 (21.46), and 27.4 (26.58); at Week 52 (n=398), they were 32.9 (21.46) for RR, 25.1 (21.66) for RP, and 30.1 (26.40) for EF.

Conclusions:

Long-term treatment with oral rimegepant 75 mg taken every other day for preventive treatment and up to once daily on nonscheduled days as needed for acute treatment was associated with improvements in migraine-specific QoL.

10.1212/WNL.0000000000202061