To characterize and compare mapped migraine-specific quality of life (MSQ v2.1) scores to EQ-5D utility values in migraineurs treated with rimegepant 75mg or placebo.

The main goal of migraine prevention is to reduce the frequency and severity of monthly migraine days (MMDs); treatment is recommended for individuals with ≥4 MMDs. A recent multicenter, phase 2/3, randomized, double-blind, placebo-controlled trial (BHV3000-305; NCT03732638) found rimegepant to be effective for preventive treatment of migraine when taken every other day (EOD).

Patients were randomized to receive rimegepant 75mg EOD or placebo for up to 12-weeks. Patients were allowed to use acute headache treatments (including triptans, nonsteroidal anti-inflammatory drugs, acetaminophen, antiemetics) as needed. MSQv2.1, characterized by the role function-preventive, role function-restrictive, and emotional function domains, was mapped to EQ-5D utilities using separate validated algorithms for episodic (77%) and chronic migraine (23%) patients. EQ-5D utilities represent the strength of an individual’s preference for specific health states or condition, using a scale anchored at 1 (full health) and 0 (dead). Change from baseline in MMDs were also examined. Outcomes were assessed at baseline and week 12. The Wilcoxon rank sum test was used to test for differences between treatment groups.

At baseline, data were available for 695 patients: 347 placebo and 348 rimegepant patients. Baseline MMDs and EQ-5D utilities were similar between trial arms: 9.89 for placebo and 10.26 for rimegepant in terms of MMDs, and 0.620 for placebo and 0.629 for rimegepant in terms of EQ-5D. For both arms, outcomes improved from baseline to week 12; -3.65 MMD change for placebo and -4.76 for rimegepant. By end-of-study, utilities increased by +0.08 in the placebo arm and +0.10 for rimegepant (p-value = 0.009).

In comparison with placebo, Rimegepant 75mg is associated with greater improvement in MMDs and in EQ-5D utilities.