Systematic review and meta-analysis on the efficacy and safety of rimegepant for migraine

Objective:

To assess the efficacy and safety of rimegepant in the treatment of migraines, including its role in both acute management and prevention.

Key Findings:

• Rimegepant significantly alleviated pain (RR = 1.34; 95% CI 1.27–1.41; p < 0.05) across 5 trials with 2,715 subjects receiving rimegepant and 2,850 in the control group.
• Rimegepant provided relief from the Most Bothersome Symptom (MBS) 2 hours post-treatment (RR = 1.38; 95% CI 1.28–1.49; p < 0.05).
• No significant difference in pain recurrence from 2 to 48 hours (RR = 1.16; 95% CI 0.99–1.37; p > 0.05).
• No significant variation in adverse events between rimegepant and control groups (RR = 1.12; 95% CI 0.97–1.28; p > 0.05).

Interpretation:

Rimegepant is effective for acute migraine management and is generally well tolerated, but does not significantly prevent pain recurrence within 48 hours, highlighting the need for further research.

Limitations:

• Limited quality and quantity of trials included in the analysis, with potential biases affecting results.
• Need for validation through larger, multicenter randomized controlled studies.

Conclusion:

Rimegepant shows promise in acute migraine treatment, but further research is necessary to confirm its efficacy in preventing pain recurrence.