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Comparative Study
. 2025 Jul;45(7):3331024251352849.
doi: 10.1177/03331024251352849. Epub 2025 Jul 27.

A comparison of the persistence of acute treatment with rimegepant versus oral triptans in patients with migraine: A retrospective analysis of US claims data

Stewart J Tepper  1 , Aaron Jenkins  2 , Carl Henriksen  3 , Feng Dai  4 , Jo Atkinson  5 , Lucy Abraham  2 , Astrid Gendolla  6
Affiliations
Free article
Comparative Study

A comparison of the persistence of acute treatment with rimegepant versus oral triptans in patients with migraine: A retrospective analysis of US claims data

Stewart J Tepper et al. Cephalalgia. 2025 Jul.
Free article

Abstract

BackgroundThis study compared persistence of patients initiating rimegepant versus oral triptans for the acute treatment of migraine.MethodsA retrospective cohort analysis was conducted using US MarketScan claims data (1 March 2019 to 30 June 2023) among commercially- and US federal Medicare-insured migraine patients initiating rimegepant or oral triptans. Persistence was defined as having ≥1 refill within 12 months of initial prescription and was compared between propensity score-matched rimegepant and triptan cohorts.ResultsBefore matching, 13,599 patients were identified in the rimegepant cohort and 38,127 in the triptan cohort. After matching, each cohort included 9909 patients. Significantly more rimegepant patients were persistent (75.8%) versus triptan patients (53.5%) (odds ratio [OR] 2.72, 95% confidence interval [CI] 2.56-2.90). Subgroup analyses showed similar trends for rimegepant versus specific triptans (rizatriptan: OR 2.49 [95% CI 2.33-2.67], and sumatriptan: OR 2.92 [95% CI 2.73-3.12]) and in patients with chronic migraine (OR 2.86 [95% CI 2.53-3.23]).ConclusionsThis study provides compelling evidence that rimegepant is associated with greater persistence than oral triptans for real-world acute treatment of migraine. Rimegepant is a favorable option for patients seeking effective and tolerable long-term treatment, particularly for those with insufficient response, intolerability, or contraindications to triptans.

Keywords: acute treatment; migraine; persistence; real-world data; rimegepant; triptans.

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Conflict of interest statement

Declaration of conflicting interestsThe authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: SJT reports financial support from the following: (Research funding) Abbvie, Aeon, Amgen, Annovis, Axsome, Cassava, Cognition, Eli Lilly, Inhibikase, Ipsen, Lundbeck, Merz, Neurolief, Pfizer, PrecisionMed, Revance, Scilex, Suven, UCB; (honoraria from consulting and advisory boards) Abbvie, Aeon, Alphasights, Amgen, Aruene/eNeura, Atheneum, Axsome Therapeutics, Bausch Health, Becker Pharmaceutical Consulting, Catch Therapeutics, ClearView Healthcare Partners, ClickTherapeutics, CoolTech, CRG, Decision Resources, Defined Health, DRG, DocDelta, Dr Reddy's, Eli Lilly, ExpertConnect, FCB Health, Fenix, Gilmartin Capital, GLG, Guidepoint Global, Health Advances, Health Science Communications, HMP Communications, Impel, Initiator Pharma, InteractiveForums, IQVIA, Keyquest, Ki Health Partners, Krog and Partners, Lundbeck, M3 Global Research, Magellan Health, Magnolia Innovation, Miravo Healthcare, MJH Holdings, Neurofront Therapeutics, Neurolief, Nocira, Novartis, P Value Communications, Pain Insights, Inc, Palion Medical, Perfood, Pfizer, Pulmatrix, Putnam Associates, Rehaler, SAI MedPartners, Satsuma, Scilex, Slingshot Insights, Spherix Global Insights, Strategy Inc, Synapse Medical Communication, System Analytic, Taylor and Francis, Tegus, Teva, Theranica, Third Bridge, Tonix, Trinity Partners, Unity HA, Vial, XOC; (salary) Dartmouth-Hitchcock Medical Center, Thomas Jefferson University, Ki Health Partners; (Speakers Bureau) AbbVie, Dr. Reddy's, Eli Lilly, Lundbeck, Pfizer, Scilex, Teva, Tonix; (CME honoraria) American Academy of Neurology, American Headache Society, Annenberg Center for Health Sciences, Catamount Medical Education, Consortium for Research Education Social Awareness and Training In Neurosciences, Diamond Education Foundation, Forefront Collaborative, Haymarket Medical Education, HMP Global, Medical Education Speakers Network, Medical Learning Institute Peerview, Migraine Association of Ireland, Miller Medical Education, National Association for Continuing Education, North American Center for CME, The Ohio State University, Physicians’ Education Resource, PlatformQ Education, Primed, Vindico Medical Education, WebMD/Medscape.AJ, FD, JA, and LA are employed by and own stock or hold stock options in Pfizer.CH is a contract programmer for Pfizer.AG reports financial support for advisory boards, consulting and speaker honoraria from: Grünenthal, Mundipharma, Abbvie/Allergan, Lilly, Teva, Amgen, Novartis, Hormosan, Stada, Lundbeck, Pfizer, Hexal, Esanum, Perfood, Medscape, streamed up, Ärztekammer Nordrhein, Ärztekammer Westfalen Lippe, DGS, Regionalbeauftragte der DMKG.

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