Medication Preference, Satisfaction, and Clinical Improvement Among Adults Receiving Long-Term Treatment With Rimegepant for Migraine
Kathleen Mullin1, Jelena Pavlovic2, Susan Hutchinson3, Richard Lipton2, Christopher Jensen4, Alexandra Thiry4, Lisa Kamen4, Robert Croop4
1New England Institute for Neurology and Headache, 2Albert Einstein College of Medicine, 3Orange County Migraine & Headache Center, 4Biohaven Pharmaceuticals
Objective:

Assess preference for and satisfaction with rimegepant as well as clinical global impression of change (CGI-C) over a 1-year open-label extension (OLE) phase in which rimegepant was used for both preventive and acute treatment of migraine.

Background:

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

Design/Methods:

This 1-year OLE phase of a 12-week, phase 2/3, randomized, double-blind, placebo-controlled study (NCT03732638) included adults aged ≥18 years with a history of 4 to 18 moderate to severe monthly migraine attacks. Subjects who completed 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 every other day for preventive treatment of migraine for 52 weeks. On nonscheduled dosing days, subjects could take rimegepant 75 mg up to once per day as needed for acute treatment of migraine. Exploratory objectives in this study included evaluating the effect of rimegepant on Preference of Medication (PoM), Satisfaction with Medication (SM), and CGI-C. The PoM, SM, and CGI-C were evaluated at Weeks 12 and 52 of the OLE phase (ie, overall study Weeks 24 and 64), and percentages (95% CIs) were calculated.

Results:
At Week 12 (n=357) and Week 52 (n=246), respectively, 82.6% (78.3, 86.2) and 85.2% (80.4, 89.0) of subjects preferred rimegepant to previous migraine treatments; 32.7% (28.2, 37.6) and 47.2% (41.5, 53.0) of subjects were completely satisfied with rimegepant (a majority of the remaining subjects were very satisfied); and 95.1% (92.9, 96.7) and 98.3% (96.4, 99.2) of subjects were considered improved on the CGI-C scale.
Conclusions:

With long-term dosing of open-label rimegepant for both preventive treatment and acute treatment of migraine, the vast majority of subjects preferred rimegepant to prior migraine medications, were satisfied with rimegepant, and experienced clinical improvement.

10.1212/WNL.0000000000202064