What is Nurtec ODT (rimegepant) used for and how does it work?
Nurtec ODT is a migraine medication that is used in adults:
- To treat migraines when they occur (they can be migraines with or without aura).
- To prevent episodic migraines.
Nurtec ODT (rimegepant) works by blocking the calcitonin gene-related peptide (CGRP) receptor.
- People who have a migraine have high levels of a protein called CGRP.
- The CGRP protein binds and activates CGRP receptors.
- When the CGRP receptor is activated it is believed this causes the migraine attack with migraine symptoms.
- The Nurtec ODT works by blocking the CGRP receptor, this means that the receptor can not be activated, so helps prevent migraines or it helps reduce migraine symptoms if a migraine develops.
How fast does Nurtec work?
Nurtec is an orally disintegrating tablet (ODT) that dissolves in the mouth without the need to take it with a glass of water. Because it dissolves in the mouth it is absorbed into the bloodstream quickly and can start working within an hour, with some people being able to get back to their normal activities after this time. It takes 1.5 hours for Nurtec to reach the maximum concentration in the body.
How effective is Nurtec for treating an acute migraine?
In the clinical study (Trial 1/NCT03461757) using Nurtec 75mg ODT or placebo pill they looked at the percentage of patients who were free from pain or free from their most bothersome migraine symptom after two hours.
Percentage of patients pain free after 2 hours
When looking at the percentage of patients from the treatment group, including all age groups, races, men and women, who were pain free after 2 hours:
- The Nurtec group had 21.2% patients pain free.
- The placebo group had 10.9% patients pain free.
- The Nurtec ODT group had 10.3% more patients pain free after 2 hours compared to the placebo group (21.2%- 10.9%=10.3%).
Table of Percentage of patients pain free after 2 hours
|Placebo||Nurtec ODT 75mg||Difference|
|Age < 40||11.5%||21.1%||9.60%|
|Age > 40||10.2%||21.4%||11.20%|
Percentage of Patients with Absence of their Most Bothersome Migraine Symptom
The study also looked at the absence in the most bothersome symptom (MBS) after 2 hours after dosing. MBS included photophobia, phonophobia, or nausea.
- In the treatment group Nurtec ODT was effective at eliminating the MBS in 35.1% of patients.
- The placebo was effective at eliminating the MBS in 26.8% of patients.
- Nurtec ODT was 8.30% more effective than that placebo group at eliminating the MBS 2 hours after dosing (35.1%- 26.8%= 8.30%).
Table of Percentage of Patients with Absence of their Most Bothersome Migraine Symptom
|Placebo||Nurtec ODT 75mg||Difference|
|Age < 40||28.0%||34.6%||6.60%|
|Age > 40||25.5%||35.7%||10.20%|
How effective is Nurtec ODT at preventing Migraines?
The clinical trial (Study 2; NCT03732638) looked at how effective Nurtec ODT was in preventing migraines. The study was a placebo controlled study with one group having Nurtec ODT and the other group receiving placebo, over a 3 month period. The number of migraines was measured for 4 weeks before patients started the trial and then compared the number of migraines in the last 4 weeks (week 9-12) of the trial.
- The Nurtec ODT group had a decrease in 4.3 migraine days per month.
- The placebo group had a decrease of 3.5 migraine days per month.
- The difference between the two groups was 0.8 days (4.3-3.5=0.8 day).
- This means that the Nurtec ODT reduced or prevented the number of migraine days by 0.8 day over a month when compared to the placebo group.
- Nurtec ODT treats migraines with or without aura, and also is taken to prevent episodic migraines.
- Nurtec ODT works by blocking the CGRP receptor, this means the receptor cannot be activated so the number of migraines can be decreased or symptoms of migraine are reduced.
- Oral rimegepant for preventive treatment of migraine: a phase 2/3, randomised, double-blind, placebo-controlled trial: https://pubmed.ncbi.nlm.nih.gov/33338437/
- FDA DRUG TRIALS SNAPSHOT SUMMARY NURTEC ODT: https://www.fda.gov/drugs/development-approval-process-drugs/drug-trials-snapshots-nurtec-odt
- Nurtec ODT Professional Medication Information: https://www.drugs.com/pro/nurtec-odt.html
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