Migraine attack

NICE green lights first oral treatment for migraine attacks in move that could benefit 145,000 people

Almost 150,000 people in England are set to benefit from a new treatment for migraines, the National Institute for Health and Care Excellence (NICE) has announced.

In final draft guidance, NICE has recommended rimegepant for adults who have a minimum of four migraines per month but less than 15.

Clinical trial findings indicate that rimegepant prevents migraines better than a placebo treatment for those who have already tried three different treatments.

The treatment works by stopping the release of a protein that is responsible for the sharp pain experienced during migraines.

Rimegepant is taken in wafer-form and dissolves under a person’s tongue – the announcement signals the first time NICE has recommended an oral treatment for this specific condition.

NICE’s director of medicines evaluation, Helen Knight, said: “Each year the lives of millions of people in England are blighted by migraine attacks. They can be extremely debilitating and can significantly affect a person’s quality of life.

“In comments received during consultation on the previous draft guidance, patients and carers described migraine as an invisible disability that affects all aspects of life including family, social activities, mental health, finances, and education.”

More than 5.6 million people are estimated to experience episodic migraines in England, with the figure for those suffering daily around 190,000.

Drugs that are primarily used for other conditions – like beta blockers, antidepressants and epilepsy medications – make up the current options for preventing migraines.

If these prove to be ineffective, NICE recommends erenumab, fremanezumab or galcanezumab, which are administered via injections.

NICE say that if rimegepant is among those deemed suitable for the patient, the least expensive should be used. Final guidance on rimegepant is expected this month.

NHE March/April 2024

NHE March/April 2024

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