Susan Hutchinson, MD: The Potential of the Gepant Class in Acute Migraine

Acute migraine therapy classes such as the triptans, of which sumatriptan is considered somewhat of the gold standard, while efficacious in the treatment of migraine attacks, are often accompanied by unwanted adverse events (AEs) in the patients who use them. Although they don’t occur in every patient, their presence has led to increasing rates of poor adherence to medications, with some patients even being driven toward opioids and other painkillers to handle acute migraine attacks.

Now, however, a new glass of oral calcitonin gene-related peptide (CGRP) antagonists including rimegepant, ubrogepant, and atogepant, have displayed somewhat comparable efficacy in clinical trials without the high rates of AEs such as cardiovascular issues. It seems, pending regulatory approval, that these medicines hold the potential to help fill in the gaps for those individuals for who triptans are unsuccessful.

To find out more about these therapies and the reasons why patients fail to use their acute medications, NeurologyLive spoke with Susan Hutchinson, MD, director, Orange County Migraine and Headache Center, about these therapies at the 2019 American Headache Society (AHS) Annual Meeting, July 11-14, 2019, in Philadelphia, Pennsylvania.