KOL Views: Comparing Allergan’s ubrogepant, Biohaven’s rimegepant versus one another and acute migraine incumbents

Biohaven Pharmaceutical’s rimegepant met the co-primary endpoints in a pair of Phase III trials to treat acute migraine this week, but the magnitude of benefit on pain relief looks less impressive than that of Allergan’s ubrogepant. In contrast, Biohaven’s small molecule CGRP inhibitor may have a leg up on safety relative to its rival, as the agent was not tied to an imbalance in liver enzyme elevations.

To provide FirstWord readers with rapid feedback on how the compounds stack up against one another and relative to the commercially available competition, we are hosting an expert call with a key opinion leader (KOL) later this week.

Key topics that will be discussed during the call include, among other things… how do the relative efficacy and safety profiles of rimegepant and ubrogepant measure up; rimegepant achieved statistical significance on pain freedom and relief from most bothersome symptom after two hours, but how clinically meaningful were the results; how concerning is ubrogepant’s liver toxicity signal; where do you see CGRP inhibitors fitting in against marketed options like triptans; which CGRP inhibitor would you reach for first at this point; based on the late separation of curves observed in Phase III data with rimegepant, how optimistic are you that an orally disintegrating tablet (ODT) formulation with more rapid onset might thread the needle by offering efficacy at least as good as ubrogepant but with better safety; thoughts on how a 25-mg dose of ubrogepant is likely to fare in still-ongoing Phase III trial relative to 50 mg and 100 mg doses; how might the availability of Eli Lilly’s oral 5-HT1F agonist lasmiditan change interest in or adoption of CGRP inhibitors?

Ask the expert!

Furthermore, we invite FirstWord Pharma readers to submit their own questions for consideration. Please click here to do so. We can't guarantee that all questions submitted will be asked due to time constraints, but we will do our utmost to cover the important issues relating to the commercial prospects for CGRP inhibitors in the acute migraine setting.

We endeavour to provide feedback from KOLs as quickly as possible. Interview content will be published for FirstWord Pharma PLUS subscribers to read. To be notified when the interview content is available please click here.

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As always, FirstWord would very much like to receive your feedback and suggestions.

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