Rimegepant - a breakthrough drug for migraine treatment - literature review
DOI:
https://doi.org/10.12775/QS.2024.19.54030Keywords
CGRP, gepant, headache, rimegepant, migraine, CGRP receptor antagonistAbstract
Migraine is a chronic condition that manifests itself periodically. It is characterized by recurrent, severe, often hemiplegic, throbbing headaches accompanied by autonomic symptoms in the form of nausea, vomiting, hypersensitivity to noise and light. For many years, triptans have been the gold standard in the treatment of migraine, acting by constricting blood vessels and inhibiting the release of neuropeptides. However, their efficacy is not satisfactory for all patients, especially those with cardiovascular disease. In response to the need for effective and safe therapies, gepants, a new class of drugs that block the calcitonin gene-related peptide (CGRP) receptor, have emerged. Rimegepant, one of the newest representatives of gepant, has been approved for the treatment of migraine both in the acute attack phase and prophylactically. Clinical trials have shown its effectiveness in reducing the number of days with migraine and alleviating associated symptoms. Rimegepant also has a favorable safety profile, making it a promising therapeutic option for migraine patients.
This article aims to discuss in detail rimegepant as a new treatment option for migraine, including its mechanism of action, efficacy, safety profile, clinical trial and outlines the benefits of introducing this drug into standard clinical practice.
References
Amanuel, AA, Kalkidan, HA, Cristiana, A, Kaja, MA, Foad, AA, Rizwan, SA i in.Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries in 195 countries from 1990 to 2016: a systematic analysis of the global burden of disease in the 2016 study . Lancet . (2017) 390:1211–59. DOI: 10.1016/S0140-6736(17)32154-2
Olesen, J. Headache Classification Committee of the International Headache Society (IHS) The International Classification of Headache Disorders,3rd edition. Cephalalgia 2018, 38, 1–211. DOI:10.1177/0333102417738202.
Messina, R.; Huessler, E.M.; Puledda, F.; Haghdoost,F.; Lebedeva, E.R.; Diener, H.C. Safety and tolerability of monoclonal antibodies targeting the CGRP pathway and gepants in migraine prevention: A systematic review and network meta-analysis. Cephalalgia 2023, 43(3), Art. No: 3331024231152169. DOI: 10.1177/03331024231152169.
Seong, J.W.; Kim, Y.; Kwon, D.R.; Yang, C.-J.; Özçakar, L. Effectiveness of Novel Sympathetic Nerve Entrapment Point Injections for Chronic Migraine: APilot Study. Life (Basel) 2023, 14, Art. No: 57. DOI:10.3390/life14010057.
Messina, R.; Huessler, E.M.; Puledda, F.; Haghdoost, F.; Lebedeva, E.R.; Diener, H.C. Safety and tolerability of monoclonal antibodies targeting the CGRP pathway and gepants in migraine prevention: A systematic review and network meta-analysis. Cephalalgia 2023, 43(3), Art. No: 3331024231152169. DOI: 10.1177/03331024231152169.
Yang, Y.; Chen, M.; Sun, Y.; Gao, B.; Chen, Z.; Wang, Z. Safety and Efficacy of Ubrogepant for the Acute Treatment of Episodic Migraine: A Meta-Analysis of Randomized Clinical Trials. CNS Drugs 2020, 34, 463– 471. DOI: 10.1007/s40263-020-00715-7.
Robbins, M.S. Diagnosis and Management of Headache: A Review. JAMA 2021, 325, 1874–1885. DOI:10.1001/jama.2021.1640.
Richer, L.; Billinghurst, L.; Linsdell, M.A.; Russell, K.;Vandermeer, B.; Crumley, E.T.; et al. Drugs for the acute treatment of migraine in children and adolescents. Cochrane Database of Systematic Reviews 2016, 4, Art. No.: CD005220. DOI:10.1002/14651858.CD005220.pub2.
Ogunlaja, O.I.; Goadsby, P.J. Headache: Treatment update. E. Neurological Sci. 2022, 29, Art. No: 100420. DOI: 10.1016/J.ENSCI.2022.100420.
Kowacs, P.A.; Sampaio Rocha-Filho, P.A.; Peres,M.F.P.; Edvinsson, L. The history and rationale of the development of new drugs for migraine treatment. Arq. Neuropsiquiatr. 2023, 81, 1084–1097. DOI:10.1055/s-0043-1777723.
Schoonman, G.G.; Van Der Grond, J.; Kortmann, C.; Van Der Geest, R.J.; Terwindt, G.M.; Ferrari, M.D. Migraine headache is not associated with cerebral or meningeal vasodilatation - A 3T magnetic resonance angiography study. Brain 2008, 131, 2192–2200. DOI: 10.1093/BRAIN/AWN094
Altamura, C.; Brunelli, N.; Marcosano, M.; Fofi, L.; Vernieri, F. Gepants — a long way to cure: a narrative review. Neurol. Sci. 2022, 43(9), 5697-570. DOI: 10.1007/s10072-022-06184-8.
Curto, M.; Capi, M.; Cipolla, F.; Cisale, G.Y.; Martelletti, P.; Lionetto, L. Ubrogepant for the treatment of migraine. Expert Opin. Pharmacother. 2020, 21, 755–759. DOI:10.1080/14656566.2020.1721462.
Wei, S.; Lv, H.; Yang, D.; Zhang, L.; Li, X.; Ning, Y.; et al. Drug-related side effects and adverse reactions in the treatment of migraine: a bibliometric and visual analysis. Front. Neurol. 2024, 15, Art. No: 1342111. DOI: 10.3389/fneur.2024.1342111.
Chiang, C.C.; Schwedt, T.J. Calcitonin gene-related peptide (CGRP)-targeted therapies as preventive and acute treatments for migraine—The monoclonal antibodies and gepants. Prog. Brain Res. 2020, 255, 143–170. DOI: 10.1016/bs.pbr.2020.06.019.
MacDonald, D.I.; Jayabalan, M.; Seaman, J.; Nickolls, A.; Chesler, A. Pain persists in mice lacking both Substance P and CGRPα signaling. BioRxiv 2023.11.15.567208; doi: https://doi.org/10.1 101/2023.11.15.567208
Headache Classification International Headache Society (IHS) Committee International Classification of Headache Disorders, 3rd Edition Cephalalgia . (2018) 38:1–211. doi: 10.1177/0333102417738202
Moreno-Ajona, D.; Chan, C.; Villar-Martínez, M.D.; Goadsby, P.J. Targeting CGRP and 5-HT1F Receptors for the Acute Therapy of Migraine: A Literature Review. Headache 2019, 59, 3–19. DOI: 10.1111/HEAD.13582.
Peroutka, S.J. Neurogenic inflammation and migrane: Implications for therapeutics. Mol. Interv. 2005, 5, 304–311. DOI: 10.1124/MI.5.5.10.
Goadsby, P.J. The pharmacology of headache. Prog. Neurobiol. 2000, 62, 509–525. DOI: 10.1016/S0301-0082(00)00010-1.
Blair, H.A. Rimegepant: A Review in the Acute Treatment and Preventive Treatment of Migraine. CNS Drugs 2023, 37, 255–265. DOI: 10.1007/s40263-023-00988-8.
González-Hernández, A.; Marichal-Cancino, B.A.; MaassenVanDenBrink, A.; Villalón, C.M. Side effects associated with current and prospective antimigraine pharmacotherapies. Expert Opin. Drug Metab.Toxicol. 2018, 14, 25–41. DOI: 10.1080/17425255.2018.1416097.
Marmura, MJ, Silberstein, SD i Schwedt, TJ.Acute treatment of migraine in adults: an evaluation of the American headache society's evidence on migraine pharmacotherapy. Headache . (2015) 55:3–20. doi: 10.1111/head.12499
Summary of product characteristics - VYDURA 75 mg oral lyophilizate
https://ec.europa.eu/health/documents/community-register/2022/20220425155292/anx_155292_pl.pdf
Richard B. Lipton , dr n. med. , Robert Croop , dr n. med . , Elyse G. Stock , dr n. med. , David A. Stock , dr n. med. , Beth A. Morris , BA , Marianne Frost , MA , Gene M. Dubowchik , dr n. med. , Charles M. Conway , dr n. med. , Vladimir Coric , dr n. med . i Peter J. Goadsby , dr n. med., dr n. med. Rimegepant, doustny antagonista receptora peptydowego genu kalcytoniny, stosowany w leczeniu migreny DOI: 10.1056/NEJMoa1811090
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Copyright (c) 2024 Katarzyna Kuleta, Julia Głoskowska, Agata Frańczuk, Michalina Grzelka, Aleksandra Makłowicz, Ewelina Kopczyńska, Angelika Szpulak, Patrycja Karkos, Katarzyna Kuśmierczyk, Natalia Dolata
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