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Safety of rimegepant, an oral CGRP receptor antagonist, plus CGRP monoclonal antibodies for migraine

Headache: The Journal of Head and Face Pain Aug 20, 2020

Berman G, Croop R, Kudrow D, et al. - For the preventive treatment of migraine, researchers analyzed the tolerability and safety of oral rimegepant when used with a monoclonal antibody (mAb) targeting the calcitonin gene‐related peptide (CGRP) ligand or receptor (CGRP mAb) when used for acute treatment. They included adults with 2‐14 migraine attacks of moderate to severe pain intensity per month in this substudy nested within a multicenter, open‐label, long‐term safety study. A subgroup suffering 2‐8 attacks per month and taking a stable dose of a CGRP mAb took rimegepant 75 mg as well as required up to once daily for 12 weeks for acute treatment. There were 13 patients who were registered in the substudy, 11 of whom were women with a mean age of 49.9 years; these participants were being treated with CGRP mAbs (erenumab [n = 7], fremanezumab [n = 4], or galcanezumab [n = 2]). The authors concluded that rimegepant was well tolerated when used as an oral acute treatment in patients receiving CGRP mAbs as a preventive treatment. No safety issues were identified. To validate these results, studies involving greater populations of patients are needed.

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