Rimegepant and atogepant: novel drugs providing innovative opportunities in the management of migraine

Wells-Gatnik, William David; Pellesi, Lanfranco; Martelletti, Paolo

doi:10.1080/14737175.2024.2401558

Expert Review of Neurotherapeutics

2024

DOI: 10.1080/14737175.2024.2401558

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Rimegepant and atogepant: novel drugs providing innovative opportunities in the management of migraine

William David Wells-Gatnik,

Lanfranco Pellesi,

Paolo Martelletti

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2024

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Combining treatments for migraine prophylaxis: the state-of-the-art

Pellesi,

Garcia-Azorin,

Rubio-Beltrán

et al. 2024

J Headache Pain

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Combination treatments for migraine prophylaxis present a promising approach to addressing the diverse and complex mechanisms underlying migraine. This review explores the potential of combining oral conventional prophylactics, onabotulinumtoxin A, monoclonal antibodies (mAbs) targeting the calcitonin gene-related peptide (CGRP) pathway, and small molecule CGRP receptor antagonists (gepants). Among the most promising strategies, dual CGRP inhibition through mAbs and gepants may enhance efficacy by targeting both the CGRP peptide and its receptor, while the combination of onabotulinumtoxin A with CGRP treatments offers synergistic pain relief. Oral non-CGRP treatments, which are accessible and often prescribed for patients with comorbid conditions, provide an affordable and practical option in combination regimens. Despite the potential of these combinations, there is a lack of evidence to support their widespread inclusion in clinical guidelines. The high cost of certain combinations, such as onabotulinumtoxin A with a CGRP mAb or dual anti-CGRP mAbs, presents feasibility challenges. Further large-scale trials are needed to establish safe and effective combination protocols and solidify their role in clinical practice, particularly for treatment-resistant patients. Graphical Abstract

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Combining treatments for migraine prophylaxis: the state-of-the-art

Pellesi,

Garcia-Azorin,

Rubio-Beltrán

et al. 2024

J Headache Pain

View full text Add to dashboard Cite

show abstract

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Rimegepant and atogepant: novel drugs providing innovative opportunities in the management of migraine

Cited by 1 publication

References 73 publications

Combining treatments for migraine prophylaxis: the state-of-the-art

Combining treatments for migraine prophylaxis: the state-of-the-art

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