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First treatment for acute migraine recommended by NICE

The National Institute for Health and Care Excellence (NICE) has published final draft guidance which recommends Pfizer’s Vydura ® ▼ (rimegepant) as an option for the acute treatment of migraine with or without aura in adults.

The recommendation is 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 enough1.

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.

One in seven people in the UK are living with migraine and it can be debilitating to those affected2. Migraines are associated with a wide variety of symptoms, often including head pain, vomiting, nausea, disturbed vision, fatigue and sensitivity to light, sound and smells3.

Migraine can begin at puberty, but mostly affects those aged between 35 and 45 years4. Migraines are two to three times more common in women, with hormonal changes being a potential trigger2.

It is estimated that up to 43 million workdays are lost each year in the UK to migraine-related absenteeism2. In addition, estimates state that migraine may cost the UK economy between £6 billion and £10 billion per year in total healthcare and productivity costs2.

Earlier this year, NICE recommended rimegepant as an option for preventing episodic migraine in adults who have at least 4 and fewer than 15 migraine attacks per month, only if at least 3 preventative treatments have not worked5.

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.”

Professor Peter Goadsby, Director of NIHR Clinical Research Facility & Professor of Neurology, King’s College London commented: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.”

References

1 National Institute for Health and Care Excellence (NICE) NICE | The National Institute for Health and Care Excellence

2 The Migraine Trust.  State of the Migraine Nation Dismissed for too long, 2021. Available at: Dismissed-for-too-long_Recommendations-to-improve-migraine-care-in-the-UK.pdf. Accessed: September 2023 

3 The Migraine Trust. What is Migraine? Available at: https://migrainetrust.org/understand-migraine/what-ismigraine/#page-section-1 Accessed: September 2023

4 WHO. Headache disorders. Headache disorders (who.int)  Accessed: September 2023

5 National Institute for Health and Care Excellence. 1 Recommendations | Rimegepant for preventing migraine | Guidance | NICE Accessed: September 2023.

6 Vydura ® ▼ (rimegepant) Summary of Product Characteristics www.medicines.org.uk

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Emma Cooper
Emma Cooper
Emma is Content Manager at Pf Media.

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