The National Institute for Health and Care Excellence (NICE) has published final draft guidance on Pfizer’s Rimegepant, recommending it for the first time as a treatment for acute migraines.
Rimegepant (Vydura) is the “first and only NICE-recommended medicine that can help alleviate the misery of acute migraines, and may be considered a step-change in treatment,” shared Helen Knight, Director of medicines evaluation at the National Institute for Health and Care Excellence (NICE).
Made by Pfizer, Rimegepant (Vydura), is recommended in NICE final draft guidance for adults who have tried at least two triptans but failed to achieve adequate relief with these medicines. It is indicated for patients who experience auras and in those who do not.
The draft guidance also recommended rimegepant for adults who cannot take or tolerate triptans and nonsteroidal anti-inflammatory drugs, such as ibuprofen and aspirin; and who tried paracetamol but did not offer suitable relief.
Clinical evidence for rimegepant
The clinical trial evidence shows that rimegepant is more likely to reduce pain at two hours than a placebo treatment, according to NICE.
Rimegepant’s mechanism of action is that such that it stops the release of a protein around the brain called calcitonin gene-related peptide (CGRP). This peptide is thought to be responsible for the severe pain associated with migraine attacks.
Currently, when triptans are ineffective, not tolerated, or contraindicated, no further standard treatment is available. Thus there is great unmet need for this condition in the UK. Therefore, as the first treatment to be recommended by NICE for treating this condition, it will be available on to around 13,000 people. NICE deemed that the medicine to be a cost-effective option on the NHS.
NICE stated that it plans to publish its final recommendations on the small molecule CGRP antagonist rimegepant in October 2023.
NICE’s treatment recommendation for episodic migraines
At the beginning of June 2023, NICE recommended oral rimegepant in final draft guidance as a treatment for episodic migraines. This enables up to 145,000 patients to access the treatment on the NHS.
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