Nurtec ODT (rimegepant ODT) / Pfizer - LARVOL DELTA

A comparison of the persistence of acute treatment with rimegepant versus oral triptans in patients with migraine: A retrospective analysis of US claims data. (PubMed, Cephalalgia) - "Subgroup analyses showed similar trends for rimegepant versus specific triptans (rizatriptan: OR 2.49 [95% CI 2.33-2.67], and sumatriptan: OR 2.92 [95% CI 2.73-3.12]) and in patients with chronic migraine (OR 2.86 [95% CI 2.53-3.23]).ConclusionsThis study provides compelling evidence that rimegepant is associated with greater persistence than oral triptans for real-world acute treatment of migraine. Rimegepant is a favorable option for patients seeking effective and tolerable long-term treatment, particularly for those with insufficient response, intolerability, or contraindications to triptans."

Journal • Retrospective data • CNS Disorders • Migraine • Pain

A randomized open-label study to evaluate the effectiveness and safety of once-daily rimegepant 75 mg orally disintegrating tablet for the short-term preventive treatment of fasting-triggered headache in individuals with migraine. (PubMed, Cephalalgia) - "Most participants (82.4%) reported being satisfied, very satisfied, or extremely satisfied with rimegepant at end of treatment. No AEs were reported.ConclusionsQD rimegepant 75 mg ODT may be effective and well tolerated for short-term prevention of fasting-triggered headache in individuals with migraine."

Clinical • Journal • CNS Disorders • Migraine • Pain

Comparative Efficacy of Over-the-Counter versus Oral Prescription Medications for Acute Treatment of Episodic Migraine – A Meta-Analysis (PAINWeek 2025) - "Background: Oral over-the-counter (OTC) analgesics such as acetaminophen-aspirin-caffeine (AAC) and ibuprofen (IBU) are widely used as first-line treatments for episodic migraine. Recently approved oral prescription (Rx) agents including gepants (ubrogepant [UBR], rimegepant [RIM]) and a selective 5-HT1F agonist lasmiditan (LAS), offer alternative options... Thirty two studies evaluating OTC and Rx oral treatments for episodic migraine were included in the meta-analysis. All active treatments were superior to placebo across pain and associated symptom endpoints. For two-hour pain relief, the highest efficacy was observed with ibuprofen 400–600 mg (RR: up to 2.21) and AAC (RR: 1.77)."

Retrospective data • CNS Disorders • Migraine • Pain

Efficacy and Tolerability of Rimegepant for the Acute Treatment of Migraine in Adults Unsuitable for Triptan Use (clinicaltrials.gov) - P4 | N=632 | Completed | Sponsor: Pfizer | Active, not recruiting ➔ Completed

Trial completion • CNS Disorders • Migraine • Pain

Efficacy and Tolerability of Rimegepant for the Prevention of Migraine in Adults With History of Inadequate Response to Oral Preventive Medications (clinicaltrials.gov) - P4 | N=658 | Completed | Sponsor: Pfizer | Active, not recruiting ➔ Completed

Trial completion • CNS Disorders • Migraine • Pain

Oral rimegepant as a preventive treatment of migraine: a plain language summary of a clinical study. (PubMed, Pain Manag) - No abstract available

Journal • CNS Disorders • Migraine • Pain

Reduction of opioid and barbiturate use following initiation of rimegepant for migraine in the United States. (PubMed, Headache) - "Rimegepant initiation was associated with reductions in utilization of opioids and butalbital, including in individuals using preventive treatment for migraine, and with reduction of opioid utilization in individuals with problematic opioid use."

Journal • Addiction (Opioid and Alcohol) • CNS Disorders • Migraine • Pain

Early Experience Treating Vestibular Migraine with Small Molecule CGRP Antagonists (AAO-HNSF 2025) - "The gepants used included ubrogepant, rimegepant, atogepant, and zavegepant. Gepants can be effective medications for the treatment of vestibular migraine."

CNS Disorders • Migraine • Otorhinolaryngology • Pain • Vertigo

Rimegepant safety and patient-reported outcomes among triptan-naïve, triptan-using, and triptan-failure participants: Subgroup analysis of an open-label, multicenter study. (PubMed, Cephalalgia) - "Rimegepant-related AEs (17.7-23.2%), treatment discontinuations (1.6-3.8%) and the most common AE (upper respiratory tract infection, 7.7-9.5%) were consistent across subgroups. After long-term treatment, the proportion of participants who preferred rimegepant to their previous medication was >75% in all triptan subgroups.ConclusionsLong-term acute treatment of migraine with rimegepant 75 mg up to once daily was safe and well tolerated in triptan-naïve participants, current triptan users and those with single or multiple historical triptan discontinuations.Trial RegistrationNCT03266588."

Clinical • Journal • CNS Disorders • Infectious Disease • Migraine • Pain • Respiratory Diseases

CORRELATE-UK: Consistency of Response With Rimegepant in Acute Treatment of Migraine (clinicaltrials.gov) - P=N/A | N=250 | Not yet recruiting | Sponsor: Pfizer | Trial completion date: Sep 2026 ➔ Mar 2026 | Initiation date: Apr 2025 ➔ Aug 2025 | Trial primary completion date: Sep 2026 ➔ Mar 2026

Trial completion date • Trial initiation date • Trial primary completion date • CNS Disorders • Migraine • Pain

Survey Data Highlights Real-World Use of Rimegepant for Short-Term Migraine Prevention (NeurologyLive) - "A cross-sectional U.S. survey evaluating real-world use of rimegepant (Nurtec ODT; Biohaven) in adults with migraine suggests that short-term prevention (STP) is a flexible and practical treatment strategy, particularly for patients with predictable migraine patterns and triggers. The survey also identified demographic groups and usage characteristics among individuals using rimegepant for STP, acute-only use, and long-term prevention (LTP). Of the 425 patients surveyed, 152 were STP users, 190 were acute-only users, and 83 were LTP users. STP users represented a demographically distinct group, as they were more likely to be male (35.5%) compared with acute-only (19.5%) and LTP users (20.5%). A higher proportion of STP users identified as Hispanic or Latino (19.7%) compared with 12.6% of acute-only and 9.6% of LTP users. They were also more likely to be employed either full or part-time (73.7%) and to have completed graduate school (19.1%)."

Real-world • Migraine • Pain

Population Pharmacokinetic Modeling of the Oral Calcitonin Gene-Related Peptide Receptor Antagonist Rimegepant in Adults. (PubMed, CPT Pharmacometrics Syst Pharmacol) - "Statistically significant covariates included empirical allometric body weight-based scaling exponents (0.75 for CL/F and Q/F and 1 for Vc/F and Vp/F); severe/moderate hepatic impairment and fluconazole/itraconazole co-administration on CL/F; fed status, dose on relative bioavailability; and fed status, itraconazole co-administration, and capsule and ODT formulations on transition absorption rate constant. Only severe hepatic impairment and co-administration of itraconazole resulted in a clinically significant decrease in rimegepant CL/F, supporting the recommendation to avoid rimegepant administration in patients with severe hepatic impairment or with a strong CYP3A4 inhibitor."

Journal • PK/PD data • CNS Disorders • Hepatology • Liver Failure • Migraine • Pain

A 52-week open-label extension study to evaluate the safety and efficacy of oral rimegepant for the preventive treatment of migraine. (PubMed, Headache) - P2/3 | "The OLE data showed favorable tolerability and sustained and increasing treatment benefits with rimegepant 75 mg (EOD and as-needed dosing) over 52 weeks for the preventive treatment of migraine. NCT03732638."

Clinical • Journal • CNS Disorders • Constipation • Gastroenterology • Gastrointestinal Disorder • Infectious Disease • Migraine • Pain • Respiratory Diseases

Efficacy and safety of rimegepant for the acute treatment of migraine in Japan: A dose-ranging, double-blind, randomized controlled trial. (PubMed, Headache) - P3 | "This randomized trial was designed to test the effectiveness and safety of rimegepant for the acute treatment of migraine among adults in Japan. Results indicated that rimegepant was more effective than placebo, and the 75 mg dose was observed to be more effective than the 25 mg dose. These results are similar to previous findings from clinical studies in other countries, and suggest that rimegepant can help patients with migraine in Japan."

Journal • CNS Disorders • Migraine • Pain

Acute Migraine Treatment in the ED With Gepants (clinicaltrials.gov) - P4 | N=100 | Recruiting | Sponsor: Icahn School of Medicine at Mount Sinai | Not yet recruiting ➔ Recruiting

Enrollment open • CNS Disorders • Migraine • Pain

REVIVAL: The R-E-V-I-V-A-L Study (clinicaltrials.gov) - P2 | N=240 | Active, not recruiting | Sponsor: Second Affiliated Hospital, School of Medicine, Zhejiang University | Not yet recruiting ➔ Active, not recruiting

Enrollment closed • CNS Disorders • Migraine • Pain

Dual calcitonin gene-related peptide antagonists for chronic migraine prevention (AHS 2025) - "These medications are divided into monoclonal antibodies, "-mAbs" (erenumab, fremanezumab, galcanezumab, and eptinezumab) and small molecule "-gepants" (rimegepant and atogepant)...Common prior or concurrent non-CGRP antagonist migraine preventive medications included topiramate (84%), tricyclic antidepressants (76%), and onabotulinumtoxinA (73%)... In our small sample, dual preventive CGRP antagonist use was well-tolerated and may be considered for patients with chronic migraine who are resistant to usual treatment. However, larger studies are needed to confirm the safety and efficacy of this approach."

CNS Disorders • Depression • Migraine • Mood Disorders • Pain • Psychiatry

Longitudinal effects of CGRP pathway-targeting migraine therapies on blood pressure and body mass index: A 12-month retrospective analysis (AHS 2025) - " Using data from electronic health records at Jefferson Headache Center, we conducted a retrospective study of adult patients with naïve use of either gepants (atogepant, rimegepant) or CGRP mAbs (erenumab, fremanezumab, galcanezumab) for migraine prevention. These findings suggest that most CGRP pathway-targeting migraine medications have negligible effects on monthly changes in BP over one year. These BP differences were small in magnitude and of unclear clinical significance. Study limitations include the unbalanced distribution of medications and potential changes in antihypertensive medication regimens during the one-year study period that could not be fully captured in our model."

Retrospective data • CNS Disorders • Migraine • Pain

Characteristics and eptinezumab infusion experience in participants in whom ≥1 prior preventive anti-CGRP treatment had failed: Interim results of an ongoing real-world study (AHS 2025) - "INFUSE includes adults ≥18 years of age with a diagnosis of migraine in whom ≥1 preventive a-CGRP treatment had failed (erenumab, fremanezumab, galcanezumab, atogepant, or rimegepant [prescribed every other day]). Results of this interim analysis of the INFUSE study indicate that individuals with migraine initiating eptinezumab treatment after ≥1 prior a-CGRP preventive treatment had failed typically have a long history of disease, severe migraine, and have cycled through three or more a-CGRP preventive treatments. The level of concern about initiating an IV treatment was low, and participants generally had a positive infusion experience."

Clinical • Real-world • Real-world evidence • CNS Disorders • Migraine • Pain • Psychiatry

Adverse events associated with gepants: a pharmacovigilance analysis based on the FDA adverse event reporting system. (PubMed, J Headache Pain) - "The present pharmacovigilance study systematically revealed the significant risk signals of gepants. The common AEs and unique AEs of the four gepants were also identified and explored. Our results would provide valuable reference for the safe use of gepants, guiding personalized drug selection in clinical practice."

Adverse events • Journal • CNS Disorders • Constipation • Fatigue • Gastroenterology • Gastrointestinal Disorder • Migraine • Pain

Evaluation of unmet needs and quality-of-care indicators among patients with migraine in the United States: 2021–2022 (AHS 2025) - "Following migraine QOC indicators selected based on current literature were assessed among diagnosed migraine patients: (1) migraine-related healthcare visits: emergency department (ED), urgent care, neurology, primary care, outpatient, inpatient hospitalizations in each full calendar year, and 30-day hospital readmission following the first hospitalization; (2) medication use: acute (generic [triptans, opioids, NSAIDs, ergotamines, barbiturates, and acetaminophen] and branded [Ubrogepant, Zavegepant, Lasmiditan, Rimegepant (when the first prescription is for less or equal to 8 pills)]) and preventive (oral migraine preventive medications[OMPM; anticonvulsants, antidepressants, antihypertensives, and other oral combination medications] and branded [CGRP mAbs, Botox, Atogepant, Rimegepant (when the first prescription is for >8 pills)]) migraine treatments; (3) other migraine-related diagnoses: acute medication overuse (AMO) based on medication utilization algorithm and..."

Clinical • CNS Disorders • Migraine • Pain

Network meta-analysis comparing efficacy and safety outcomes of atogepant, rimegepant, and galcanezumab in patients with episodic migraine after including CHALLENGE-MIG trial (AHS 2025) - " The NMA included 5 randomized, controlled trials for the preventive treatment of EM (ADVANCE [atogepant 60 mg], BHV3000-305 [rimegepant 75 mg], EVOLVE-1, EVOLVE-2 [galcanezumab 120 mg], and CHALLENGE-MIG [rimegepant 75 mg, galcanezumab 120 mg]). Atogepant 60 mg demonstrated significant improvements in 3 of the 4 efficacy outcomes compared to rimegepant 75 mg and significantly increased odds of achieving ≥50% RR in MMD relative to galcanezumab 120 mg. Other efficacy outcomes were not significantly different. Atogepant 60 mg demonstrated comparable all-cause d/c and TEAEs relative to rimegepant and galcanezumab."

Retrospective data • CNS Disorders • Migraine • Pain

Number needed to treat analysis of atogepant compared to rimegepant for the preventive treatment of episodic migraine in Japanese and global participants (AHS 2025) - P2/3, P3 | "One analysis evaluated this outcome using data from the Japanese only trials for atogepant [RELEASE (NCT05861427), placebo, N = 134; atogepant 60 mg, N = 132] and rimegepant [BHV3000-309 (NCT05399485), placebo, N = 244, rimegepant 75 mg, N = 240], and a second analysis evaluated this outcome using data from global (Japan and US) trials for atogepant [ADVANCE (NCT03777059), placebo, N = 222; atogepant 60 mg, N = 231, and RELEASE] and rimegepant [BHV3000-305 (NCT03732638), placebo, N = 371; rimegepant 75 mg, N = 370, and BHV3000-309]. Atogepant had substantially lower NNTs versus placebo than rimegepant for the preventive treatment of EM across the Japanese only trials and global trials. An additional 7–14 individuals would need to be treated with rimegepant 75 mg to result in a comparable response with atogepant 60 mg. These results suggest that atogepant may be more efficacious than rimegepant for the preventive treatment of EM."

Clinical • CNS Disorders • Migraine • Pain

Long-term safety and discontinuation for rimegepant versus triptans: A matching-adjusted indirect comparison (AHS 2025) - P2/3 | "Despite the bias against rimegepant due to shorter follow-up in the zolmitriptan study, these results suggest patients were less likely to discontinue rimegepant than zolmitriptan, both due to AEs or lack of efficacy, and also less likely to experience AEs of dizziness, somnolence, paresthesia, nausea, or asthenia over 12-months of PRN use, reflecting better long-term tolerability and persistence. TABLE 1. MAIC safety and discontinuation results for rimegepant versus zolmitriptan."

Clinical • CNS Disorders • Migraine • Pain

Impact of triptan insufficient response on medication use, health care utilization, and costs: A retrospective claims study (AHS 2025) - "Substantial non-triptan acute use was observed among TIR patients over the 24-month follow-up period: migraine-related NSAIDs (48%), opioids (36%), and barbiturates (18%) as well as rimegepant (18%) and ubrogepant (16%). When compared with triptan continuers, a potential insufficient response to triptans was associated with significantly higher migraine-related HCRU, and costs."

HEOR • Retrospective data • CNS Disorders • Migraine • Pain