The National Institute of Health and Care Excellence (Nice) has recommended that a Pfizer drug be an option on the UK's NHS for migraine prevention where at least three previous treatments have failed.
The Telegraph reports that Nice said the draft guidance – now out to consultation – could mean up to 145 000 people choosing Rimegepant, also called Vydura which is taken as a wafer that dissolves under the tongue and costs around £13 per tablet, taken every other day.
It works by stopping the release of a protein around the brain called calcitonin gene-related peptide, which causes intense inflammation in the coverings of the brain (the meninges) and is responsible for the severe pain associated with migraine attacks.
Current preventive treatments involve injecting drugs or using medicines such as beta-blockers and antidepressants that were designed to treat other conditions.
The draft guidance follows trials of the drugs for sufferers of “episodic migraine” – meaning they have at least four attacks per month but fewer than 15.
Those who suffer attacks even more frequently are classed as suffering from chronic migraine, and are eligible for injections.
The clinical trial evidence shows that rimegepant works better than a dummy treatment for reducing the number of episodic migraines in people who have already tried three other preventive treatments.
Helen Knight, director of medicines evaluation at Nice, said: “Rimegepant is the first oral treatment for migraine to be recommended by Nice, and for many thousands of people might be a welcome addition to existing options for a condition that is often overlooked and under-treated.”
Current treatment options for preventing migraines include drugs used to treat other conditions, like beta-blockers, antidepressants and epilepsy medications, but they often have significant side-effects and can be ineffective for some people.
If no appeals are received against the decision, final guidance is expected to be published next month.
The Telegraph article – Migraine pills could be made available for first time (Restricted access)
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Oral rimegepant an effective preventive for migraine — clinical trial
Considerable added benefit for new drug in the prophylaxis of migraine
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Migraine in children linked to anxiety, depression – Canadian meta-analysis