NICE has published final draft guidance which recommends Vydura (rimegepant) as an option for the treatment with or without aura in adults.
The institute made this recommendation with the condition only if for previous migraines at least two triptans were tried and they did not work well enough or, triptans were contraindicated or not tolerated, and nonsteroidal anti-inflammatory drugs (NSAIDs) and paracetamol were tried but did not work well enough.
Rimegepant is an oral lyophilisate (dissolving wafer) and is the first oral calcitonin gene-related peptide (CGRP) receptor antagonist for acute (taken at the onset of a migraine attack) migraine treatment recommended for use by NICE.
In its research, Pfizer found through The Migraine Trust, that one in seven people in the UK are living with migraine and it can be debilitating to those affected. The trust said migraines are associated with a wide variety of symptoms, often including head pain, vomiting, nausea, disturbed vision, fatigue and sensitivity to light, sound, and smells.
According to the World Health Organization (WHO) migraine can begin at puberty, but mostly affects those aged between 35 and 45 years. Migraines are two to three times more common in women, with hormonal changes being a potential trigger. Lady Gaga, a high profile sufferer, has been collaborating with Pfizer to raise awareness of the condition.
Women disproportionately impacted by migraine
Toby Cousens, head of hospital and internal medicine, Pfizer UK said: “Migraine can significantly interrupt people’s day to day lives, both personally and professionally, and we know women are disproportionately impacted by this condition.
“This decision is an important milestone and further expands the use of rimegepant for treatment of acute migraine in England. Pfizer is committed to supporting people living with migraine and we will continue to work with healthcare partners to improve care.”
Peter Goadsby, director of The National Institute for Health and Care Research (NIHR) clinical research facility and professor of neurology, King's College London said: “Migraine can have a debilitating impact on those living with it. Today’s decision, to offer a treatment which can be used at the onset of a migraine is a welcome step to help expand the options available to eligible patients.”
The Migraine Trust estimates that up to 43 million workdays are lost each year in the UK to migraine-related absenteeism. In addition, the trust estimates state that migraine may cost the UK economy between £6 billion and £10 billion per year in total healthcare and productivity costs.
Earlier this year, NICE recommended rimegepant as an option for preventing episodic migraine in adults who have at least four and fewer than 15 migraine attacks per month, only if at least three preventative treatments have not worked.
Meanwhile in the US, the Food and Drug Administration (FDA) approved another migraine treatment, Rizafilm, in April.