More than 145,000 people in England who experience migraines are set to benefit from a new oral treatment on the NHS, according to the National Institute for Health and Care Excellence (NICE).
Last week the drugs regulator issued final draft guidance where, for the first time, it recommended an oral treatment for preventing migraines.
“They can be extremely debilitating and can significantly affect a person’s quality of life”
Helen Knight
NICE has approved rimegepant for preventing episodic migraine in adults where at least three previous preventative treatments have failed.
The treatment has been recommended for adults who have at least four migraine attacks per month but less than 15.
The drug, sold under the brand name Vydura by Pfizer, is taken in the form of a wafer and dissolves under the tongue.
It works by blocking protein receptors from binding to the brain that can cause severe pain associated with migraine attacks.
Findings from a clinical trial revealed that rimegepant works better than a dummy treatment for reducing the number of episodic migraines in people who have already tried three preventative treatments.
NICE said it expected to publish final guidance on rimegepant for preventing episodic migraines later this month.
Helen Knight, director of medicines evaluation at NICE, 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.”
Ms Knight said that the consultation on previous draft guidance revealed that many saw migraines as “an invisible disability that affects all aspects of life” including family, social activities and mental health.
She added: “Rimegepant is the first oral treatment for migraine to be recommended by NICE and for many thousands of people it is likely to be a welcome and more convenient addition to existing options for a condition that is often overlooked and undertreated.
“Today’s draft guidance demonstrates our commitment to focusing on what matters most and getting the best care to people while ensuring value for the taxpayer.”
The announcement comes while it is estimated that more than 5.6m people in England have episodic migraines, and it is thought that some 190,000 migraine attacks are experienced every day.
Current treatment options for preventing migraine include drugs that are used primarily for treating other conditions, like beta-blockers, antidepressants and epilepsy medications.
However, these are not recommended by NICE and can have significant side effects and can also be ineffective for some people.
Other treatments available, and are recommended by NICE, are erenumab, fremanezumab or galcanezumab, all of which are given as injections.
The Migraine Trust welcomed the announcement that rimegepant will be used for preventative use, but said it was concerned that the drug had not been approved for treatment of migraines.
Chief executive of the charity, Rob Music, said: “Too many people with migraine end up with medication overuse headache as a result of their migraine treatment, which has a serious impact on their lives.
“This is an impact which is preventable if migraine is treated effectively.”
He added: “Gepants, the new class of migraine medication which rimegepant is part of, can help prevent this happening.
“While we welcome that it has been approved for the preventive treatment of migraine, we are very disappointed by the decision not to approve it for the acute treatment of migraine.”
