Date of Award
2022
Degree Type
Selective Evidence-Based Medicine Review
Degree Name
Master of Science in Health Sciences - Physician Assistant
Department
Physician Assistant Studies
Abstract
OBJECTIVE: The objective of this selective EBM review is to determine whether or not “Is rimegepant an effective treatment for acute migraine pain in adults?”
STUDY DESIGN: A systematic review of three, peer-reviewed randomized placebo-controlled trials (RCT’s).
DATA SOURCES: All studies were obtained from PubMed and were published in English in peer-reviewed journals between 2014-2019. The articles were selected based on their relevance to the clinical question posed in the objective and their inclusion of patient oriented outcomes.
OUTCOMES MEASURED: The main outcome being assessed in all articles was freedom from pain. The absence/presence of pain was self-reported by patients two hours post rimegepant/placebo dose in all trials.
RESULTS: All RCT’s found rimegepant to be superior in eliminating migraine pain compared to the placebo group. Croop et al. (2019) found that 21.2% of patients treated with rimegepant had freedom from pain 2 hours postdose while only 10.9% of patients treated with the placebo achieved freedom of pain 2 hours postdose. The study was statistically significant (p-value < 0.0001) and had a large treatment effect based on a calculated NNT of 10. Lipton et al. (2019) found that 19.6% of patients treated with rimegepant had freedom from pain 2 hours postdose while only 12.0% of patients treated with the placebo achieved freedom from pain 2 hours postdose. The study was statistically significant (p-value < 0.001) and had a large treatment effect based on a calculated NNT of 13. Marcus et al. (2014) found that 31.4% of patients treated with rimegepant had freedom from pain 2 hours postdose while only 15.3% of patients treated with the placebo achieved freedom from pain 2 hours postdose. The study was statistically significant (p-value ≤ 0.002) and had a large treatment effect based on a calculated NNT of 7.
CONCLUSIONS: All three studies found rimegepant to be more effective at eliminating acute migraine pain of moderate to severe intensity compared to the placebo. Statistically significant p-values as well as large treatment effects were found in each study. Future research should be conducted looking at safety among individuals with cardiovascular disease.
Recommended Citation
Wright, Hanson S., "Is rimegepant an effective treatment for acute migraine pain in adults?" (2022). PCOM Physician Assistant Studies Student Scholarship. 614.
https://digitalcommons.pcom.edu/pa_systematic_reviews/614