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

Background This study compared persistence of patients initiating rimegepant versus oral triptans for the acute treatment of migraine. Methods A 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. Results Before 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]). Conclusions This 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.