Introduction: Rimegepant and atogepant, two innovative oral medications for the treatment of migraine, are gaining prominence in the treatment of migraine. However, outside of specialist headache centers, these novel medications remain subjectively underutilized. While multiple rationales exist describing their underutilization, a leading factor is the complexity and clinical flexibility attributed to the individual members of the gepant medication class.
Areas Covered: This review provides a brief review of the current uses, common adverse events, and potential areas of future clinical innovation attributed to rimegepant and atogepant. A database search for the term 'Rimegepant OR Atogepant' was completed, yielding 240 individual results. Following multiple rounds of assessment that aimed to determine relevance of each individual result, 42 studies were included in the synthesis of this review.
Expert Opinion: Rimegepant and atogepant are exciting medications that demonstrate significant clinical innovation within the field of migraine therapy. While current indications are clear, data is lacking regarding the future expanded roles of these medications. Current areas of potential therapeutic innovation for rimegepant and atogepant include the pediatric population, in pregnancy and breastfeeding, in cluster headache and post-traumatic headache, and in patients that previously discontinued calcitonin gene-related peptide (CGRP) monoclonal antibody (mAb) therapy.
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Migraine treatment: Position paper of the French Headache Society.
Rev Neurol (Paris)
December 2024
Department of Neurology, Gui-de-Chauliac Hospital, CHU de Montpellier, University of Montpellier, 34000 Montpellier, France.
The French migraine management recommendations were published in 2021. However, in the last three years, new data have come to light and new drugs have been approved (eptinezumab, rimegepant and atogepant) by the European Medicines Agency that require us to take a position on their use and to update certain elements of the recommendations. The first important message concerns the position of the French Headache Society on the use of preventive treatments (monoclonal antibodies and gepants) targeting the calcitonin gene-related peptide (CGRP) pathway.
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Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK.
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- Chronic migraine affects 2-4% of adults globally and recent advances in expensive medications have prompted a review of their clinical and cost-effectiveness.
- The study analyzed data from randomised controlled trials involving 7352 adults and compared six different medications, including calcitonin gene-related peptide monoclonal antibodies, Botox, and topiramate, against placebo.
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School for Environment and Sustainability, University of Michigan, Ann Arbor, MI 48109, USA.
This retrospective study assesses the efficacy and tolerability of anti-calcitonin gene-related peptide (anti-CGRP) therapy in adolescents and young adults (ages 12-21) with migraine and chronic daily headaches unresponsive to standard treatments. Migraines in this demographic significantly impair school performance, self-esteem, psychological well-being, and cognitive health. These young patients are also particularly sensitive to the side effects of conventional medications, which are often prescribed off-label and come with high insurance denial rates.
View Article and Find Full Text PDFThe influence of pharmacodynamics and pharmacokinetics on the antimigraine efficacy and safety of novel anti-CGRPergic pharmacotherapies: a narrative review.
Expert Opin Drug Metab Toxicol
January 2025
Departamento de Farmacobiología, Cinvestav-Coapa, Ciudad de México, México.
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- Migraine is a complicated disorder, with calcitonin gene-related peptide (CGRP) playing a key role in its understanding and the development of new treatments like gepants and monoclonal antibodies, which are effective and safe for patients.
- A narrative review investigated CGRP's role in migraines and analyzed the effects of CGRP-targeted medications regarding how they work and how the body processes them.
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Rimegepant and atogepant: novel drugs providing innovative opportunities in the management of migraine.
Expert Rev Neurother
November 2024
School of Health, Unitelma Sapienza University of Rome, Rome, Italy.
Introduction: Rimegepant and atogepant, two innovative oral medications for the treatment of migraine, are gaining prominence in the treatment of migraine. However, outside of specialist headache centers, these novel medications remain subjectively underutilized. While multiple rationales exist describing their underutilization, a leading factor is the complexity and clinical flexibility attributed to the individual members of the gepant medication class.
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