Why Migraines Matter
Migraines are one of the most unpleasant conditions a person can face.
Migraines involve very painful headaches and other unpleasant symptoms such as sensitivity to light, sensitivity to sound, and nausea.
Migraine headaches affect 12% of the general population. For reasons still unknown, they are more common in women than in men.
There are currently no good treatments for migraines. Existing treatments do not work for most patients and they carry significant side effects.
A new generation of drugs seeks to address this issue with medications that target different and newly discovered mechanisms.
A recent phase III clinical trial, which is used to determine whether medication is effective and should be approved, was just published in the New England Journal of Medicine.
Phase III Clinical Trial
Rimegepant and Migraine Pain
The trial found that patients with took this medication had a significantly faster recovery from pain. However, as you can see in the chart above, this drug doesn’t stop the pain, it only helps speed up recovery.
Rimegepant and Migraine Symptoms
Unlike other headaches, migraines usually carry other symptoms which are very bothersome for patients.
The symptoms are slightly different for each patient. In order to see how effective this drug is at relieving all symptoms, researchers measured how quickly the drug relieved the worst symptom other than pain for each patient, as reported by the patients themselves.
In a similar story to the pain data reported earlier, Rimegepant sped up recovery but it didn’t stop the symptoms. They were also quite a few patients who didn’t necessarily benefit.
Effect of Rimegepant on Photophobia & Phonophobia
Researchers measured symptom relief at 2 hours as a secondary endpoint. They found that sensitivity to light, sensitivity to sound, and pain, were the symptoms that were most likely to be alleviated by Rimegepant.
Nausea, on the other hand, was not significantly alleviated by Rimegepant.
The Placebo Effect
Keys to Health
This study shows that this new drug may be effective in helping to treat migraines.
Unfortunately, this drug does not appear to be a silver bullet in stopping migraines. It only helps a minority of patients, and it only slightly speeds up recovery.
It will however be a useful tool for patients. With the immense pain of a migraine, any drug that can help would be much appreciated by many. Additionally, the results above measure the difference between the drug and a placebo control.
Because of the placebo control comparison, the difference in pain relief will likely be larger between this drug and not taking any drug at all. Placebo controls do tend to reduce symptoms despite not having any active ingredients.