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Research Article
4 January 2024

Comparative effectiveness of erenumab versus rimegepant for migraine prevention using matching-adjusted indirect comparison

Authors: Ronan Mahon [email protected], Santosh Tiwari, Mirja Koch, Matias Ferraris, Keith A Betts, Yan Wang, Sophie Gao, and Pascal ProotAuthor Info & Affiliations
Volume 13, Number 3
https://doi.org/10.57264/cer-2023-0122
PDFFormats

Abstract

Aim: To compare the efficacy of erenumab versus rimegepant as preventive treatment for patients with episodic and chronic migraine using an anchor-based matching-adjusted indirect comparison. Methods: Patients from two phase II/III trials for erenumab (NCT02066415 and NCT02456740) were pooled and weighted to match on the baseline effect modifiers (age, sex, race, baseline monthly migraine days [MMDs], and history of chronic migraine [CM]) reported in the phase II/III trial for rimegepant (NCT03732638). Four efficacy outcomes were compared between the two erenumab regimens (70 mg and 140 mg) and rimegepant, including changes in MMDs from baseline to month 1 and month 3, changes in Migraine-Specific Quality of Life Questionnaire role function – restrictive domain score from baseline to month 3, and change in disability from baseline to Month 3. Results: Compared with rimegepant, erenumab 70 mg was associated with a statistically significant reduction in MMDs at month 3 (-0.90 [-1.76, -0.03]; p = 0.042) and erenumab 140 mg was associated with statistically significant reductions in MMDs at month 1 (-0.94 [-1.70, -0.19]; p = 0.014) and month 3 (-1.28 [-2.17, -0.40]; p = 0.005). The erenumab regimens also had numerical advantages over rimegepant for other efficacy outcomes. Conclusion: In the present study, we found that erenumab had a more favorable efficacy profile than rimegepant in reducing MMDs at month 1 and month 3 for migraine prevention. These results may help with decision-making in clinical practice and can be further validated in future clinical trials or real-world studies.

Plain language summary

What was the aim of this research?

To compare the efficacy of erenumab with rimegepant as a treatment for prevention of episodic and chronic migraine.

How was the research carried out?

A matching-adjusted indirect comparison (MAIC) was conducted using clinical trial data for erenumab and rimegepant. The study assessed four efficacy outcomes: changes in MMDs from baseline to month 1 and month 3, changes in Migraine-Specific Quality of Life Questionnaire role function – restrictive domain score from baseline to month 3, and change in disability from baseline to month 3.

What were the results?

Compared with rimegepant, erenumab 70 mg was associated with a significantly larger reduction in monthly migraine days by month 3 and erenumab 140 mg was associated with significantly larger reductions in monthly migraine days by both month 1 and month 3. Additionally, both erenumab regimens demonstrated numerical advantages over rimegepant for all other efficacy outcomes.

What do the results of the study mean?

Compared with rimegepant, the erenumab regimens had a more favorable efficacy profile in reducing MMDs at month 1 and month 3 for migraine prevention.

Supplementary Material

File (supplementary materials.docx)

References

Papers of special note have been highlighted as: • of interest; •• of considerable interest
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