Richard B. Lipton, MD: Challenges of Treating Migraine

"There are lots of new drugs and new devices approved, and evidence-based behavioral methods, but the challenge is in matching the treatment to the patient. Clinical trials tell us what works, but they don't do a very good job of telling us who particular treatments will work in.”

The CGRP receptor antagonist rimegepant (Nurtec; Biohaven) was approved for the acute treatment of migraine in February 2020.¹ Recently, a multicenter, phase 2/3, randomized, double-blind, placebo-controlled trial (NCT03732638) showed that rimegepant is also effective for preventing migraine when taken every other day (QOD) and is well-tolerated in patients with the headache disorder.²

NeurologyLive spoke with study co-author Richard B. Lipton, MD, professor and vice chair of neurology, Albert Einstein College of Medicine, and director, Montefiore Headache Center, about these data to learn more about the challenges of treating migraine and the spectrum of migraine that patients may experience.

Lipton discussed how every patient is unique in their migraines, and therefore would benefit from individualized treatment. He lauded the innovation and development of new drugs and devices for treating migraine and stressed that the challenge is in matching the patient to the right treatment.

REFERENCES

1. Rimegepant Approved by FDA for the Acute Treatment of Migraine in Adults. News release. Biohaven Pharmaceuticals. February 27, 2020. Accessed January 6, 2021. https://americanheadachesociety.org/news/rimegepant-acute-migraine-treatment/
2. Kroop R, Lipton RB, Kudrow D, et al. Oral rimegepant for preventive treatment of migraine: a phase 2/3, randomised, double-blind, placebo-controlled trial. Lancet Neurol. Published online December 15, 2020. doi: 10.1016/S0140-6736(20)32544-7