Evaluate real-world effectiveness of rimegepant as an acute migraine treatment over multiple attacks.

Assessment of real-world effectiveness is important to evaluate the impact of new treatments outside of clinical trials.  

This prospective, real-world observational study of adults currently using rimegepant to treat migraine attacks was conducted using the Migraine Buddy® app. Eligible participants had 3-14 headache days within the last 30 days and planned to treat some future attacks with rimegepant.  Participants completed a: 1) baseline survey capturing demographic/clinical characteristics and current treatments; 2) 28-day daily diary assessing time to meaningful pain relief (pain reduced to a degree the patient considers meaningful), time to normal function, and treatment satisfaction; and 3) questionnaire at study completion. Effectiveness was evaluated for treated attacks over 28-days.

Of participants included (n = 146), 140 treated at least one attack with rimegepant during the study. Participants were 92.5% female, 93.8% Caucasian, with mean (SD) age of 40.1 (11.1). Migraine burden was high at study start: mean (SD) headache days in the past 30 days was 7.4 (3.0); 87% had MIDAS scores ≥11, indicating moderate-to-severe disability; 65% were using a preventive treatment, most frequently mAbs. A total of 1054 attacks were recorded in diaries; rimegepant was used to treat 706 (67.0%) attacks. The median number of attacks treated by individuals was 5 (3-6 IQR). For rimegepant-treated attacks, the proportion achieving meaningful improvements in pain and ability to function within 2 hours was 58.6% and 56.4%, respectively. For 67.3% of rimegepant-treated attacks, participants were ‘satisfied’ or ‘extremely satisfied’, overall. Meaningful pain relief was achieved within 2 hours for the first (63.6%), second (58.2%), third (59.2%), and fourth (60.0%) rimegepant-treated attacks

Meaningful pain relief and restoration of function occurred within 2 hours for the majority of attacks with high levels of population consistency from attack to attack.