NICE Endorses Rimegepant

June 2, 2023

Migraine is a debilitating neurological disorder affecting millions of people worldwide. In England, approximately 5.6 million individuals experience episodic migraines, with a staggering 190,000 migraine attacks occurring daily. To address the challenges faced by migraine sufferers, the National Institute for Health and Care Excellence (Nice) has endorsed rimegepant, also known as Vydura, as a preventive treatment. However, while the approval has been welcomed, charities have expressed disappointment regarding its limited use for acute cases of migraines.

Endorsement by Nice and Eligibility Criteria

The regulatory body, Nice, has given its endorsement for rimegepant to be made available on the NHS for migraine sufferers in England. To be eligible for this medication, adults must have experienced failure with at least three previous preventive treatments, highlighting the importance of finding effective solutions for those who have not responded to conventional therapies.

A Convenient Oral Medication

Rimegepant stands out as the first oral medication specifically recommended by Nice for preventing migraines. It offers a convenient form of treatment through a dissolvable wafer placed under the tongue. This innovative delivery method provides an alternative to injections and promises greater convenience and ease of administration for migraine sufferers.

Understanding the Mechanism of Rimegepant

Rimegepant works by blocking calcitonin gene-related peptide (CGRP), a protein responsible for causing intense inflammation and severe pain during migraine attacks. By preventing CGRP from binding to its targets in the brain, rimegepant effectively reduces the severity and frequency of migraines, offering hope for individuals affected by this neurological disorder.

Current Treatment Options and Disappointment

Migraine treatment typically involves a combination of acute and preventive approaches. Commonly used medications include beta-blockers, antidepressants, and epilepsy medications. However, these options may not be effective for everyone and can have significant side effects. This makes the endorsement of rimegepant particularly significant, offering a new preventive treatment option for those who have not responded to conventional therapies.

However, charities have expressed disappointment that rimegepant has not been approved for the acute treatment of migraines. They emphasize the importance of effective treatment to prevent medication overuse headaches, which can occur when migraine treatment is ineffective or inadequate.

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