By: Ainsley Ellison ’22
A migraine is characterized as severe head pain. People who suffer from migraines may experience a variety of symptoms, including nausea and sensitivity to light and sound. About 12 to 14% of the world’s population, around 1 billion people, suffer from migraine headaches. Over ¾ of these people have at least one migraine per month and ½ of migraine sufferers feel the pain during the attacks to be debilitating. CGRP is a protein which is released during migraine attacks that causes the pain.
Currently, the most common medicines for migraine treatment are triptan drugs. This category of drugs target serotonin receptors, which decrease inflammation and constrict blood vessels. While triptan drugs are effective for some, for others the side effects are highly unpleasant. In addition to the side effects, the constriction of blood vessels makes the drugs dangerous to people with cardiovascular disease, or CVD. However, a new category of drugs, called gepants, may be an option for those who cannot take triptan. Gepants target the pathway for CGRP so it cannot be released.
In a randomized, double-blind clinical trial done by The New England Journal of Medicine, over 1000 migraine sufferers were given either the gepant rimegepant or a placebo. The patients involved answered questions about their pain and symptoms before they took either the rimegepant or placebo. The pill was taken once pain during a migraine attack reached moderate to severe levels. 48 hours after the pill was taken, they answered the same questions.
This clinic trial was financed by the producer of rimegpant, Biohaven. Dr. Lipton is paid by and owns stock in Biohaven.
19.6% of the patients who took the rimegepant, compared to 12% of placebo patients, felt pain free after two hours. 37.6% of rimegepant patients were free from the worst symptom they experienced after two hours, while 25.2% were free in the placebo group. Minimal adverse effects were reported, including those with CVD.
Rimegepant’s initial trial had promising results after the preliminary trial. It is currently awaiting approval by the FDA.