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The first oral treatment for preventing migraines has been recommended by NICE, which could help over 145,000 people in England.
Rimegepant (also called Vydura and made by Pfizer) is recommended as an option for preventing episodic migraine in adults where at least three previous preventive treatments have failed.
The final draft guidance expected next month recommends rimegepant for adults who have at least four migraine attacks per month but less than 15.
Current treatment options for preventing migraine include drugs that are used for treating other conditions, such as beta-blockers, antidepressants and epilepsy medications. These treatments can have significant side-effects and can be ineffective for some people. Treatments offered after these have been tried include NICE-recommended erenumab, fremanezumab or galcanezumab, all of which are given as injections.
The draft guidance says if rimegepant is considered to be one of a range of suitable treatments, after discussing the advantages and disadvantages of all the options, the least expensive should be used.
190,000 migraines are experienced every day
The clinical trial evidence shows that rimegepant works better than a dummy treatment for reducing the number of episodic migraines in people who have already tried three preventive treatments.
Over 5.6m people in England are thought to have episodic migraines in England and it is estimated that 190,000 migraine attacks are experienced every day in England.
Rimegepant is taken as a wafer which dissolves under the tongue. It works by stopping the release of a protein around the brain that is responsible for the severe pain associated with migraine attacks.
Helen Knight, director of medicines evaluation at NICE, said: “Each year the lives of millions of people in England are blighted by migraine attacks. They can be extremely debilitating and can significantly affect a person’s quality of life. In comments received during consultation on the previous draft guidance, patients and carers described migraine as an invisible disability that affects all aspects of life including family, social activities, mental health, finances, education and.
“Rimegepant is the first oral treatment for migraine to be recommended by NICE and for many thousands of people it is likely to be a welcome and more convenient addition to existing options for a condition that is often overlooked and undertreated.”