Photo Credit: Peterschreiber.media

The following is a summary of “Safety of Rimegepant in Adults with Migraine and Anxiety, Depression, or Using Antidepressants: Analysis of a Multicenter, Long-Term, Open-Label Study,” published in the November 2024 issue of Pain by Kudrow et al. 

Anxiety, depression, and antidepressant use are the common comorbidities of migraine.  

Researchers conducted a retrospective study to examine the safety and tolerability of rimegepant in patients with migraine along with anxiety and depression or those using selective serotonin reuptake inhibitors (SSRIs) or other antidepressants.  

They used data from a phase II/III safety trial of rimegepant for acute migraine treatment. Participants with 2-14 moderate or severe migraine attacks per month self-administered rimegepant 75 mg as needed, up to once daily for a maximum of 52 weeks. Post-hoc subgroup analyses assessed safety based on self-reported history of anxiety or depression and current use of SSRIs or other antidepressants.  

The results showed that 1800 treated participants, 23.2% (n = 417) had a self-reported history of anxiety, 23.7% (n = 426) had depression, and 11.2% (n = 202) reported both. A total of 10.1% (n = 181) were using an SSRI, 10.8% (n = 195) were using other antidepressants, and 1.8% (n = 32) used both. Across subgroups (with anxiety, without anxiety, with depression, without depression, using SSRIs, not using SSRIs, using other antidepressants, and not using other antidepressants), similar proportions experienced adverse events (67.1%, 58.4%, 62.0%, 60.0%, 64.1%, 60.0%, 66.2%, 59.8%), serious adverse events (3.6%, 2.3%, 2.8%, 2.5%, 3.3%, 2.5%, 5.1%, 2.3%), and discontinuation of rimegepant due to adverse events (4.1%, 2.2%, 3.1%, 2.5%, 5.0%, 2.4%, 3.1%, 2.6%). Numerical improvements in various participant-reported outcomes at weeks 12 and 52 were also observed.  

They concluded the rimegepant demonstrated favorable safety and tolerability in adults with migraine who had a history of anxiety and depression or who were currently using SSRIs or other antidepressants. 

Source: link.springer.com/article/10.1007/s40122-024-00675-6