Rationale for Correct Answer
The correct answer is: Approximately 20% of people taking gepants experienced freedom from pain at 2 hours
Clinical trials have demonstrated that around 20% of participants reported no pain 2 hours after taking rimegepant 75 mg (orally disintegrating tablet), ubrogepant 50 or 100 mg (oral tablet), or zavegepant 10 mg (nasal spray) for a headache of moderate or severe intensity, while 35% to 40% reported relief from their most bothersome migraine symptom within the same timeframe.1-7
The most commonly reported adverse events varied among the gepants: ubrogepant was associated with nausea, somnolence, dry mouth, and dizziness;1,2 rimegepant with nausea;3,4 zavegepant with dysgeusia, nasal discomfort, nausea, nasal congestion, and throat irritation.5,6
Post hoc analysis indicates that ubrogepant is more effective when taken early in a migraine episode. Participants who treated their migraines while they were still mild were twice as likely to be pain free at 2 hours compared with those who treated more intense headaches. This was also true for other endpoints such as alleviating the most bothersome symptom and returning to normal function within 2 hours.8
References:
1. Dodick DW, et al. N Engl J Med. 2019;381(23):2230-41;
2. Lipton RB, et al. JAMA. 2019;322(19):1887-98;
3. Croop R, et al. Lancet. 2019;394(10200):737-45;
4. Lipton RB, et al. N Engl J Med. 2019;381(2):142-9;
5. Croop R, et al. Headache. 2022;62(9):1153-63;
6. Lipton RB, et al. Lancet Neurol. 2023;22(3):209-17;
7. Tepper D. Headache. 2020. 60(5):1037-39;
8. Lipton RB, et al. Neurology. 2022;99(17):e1905-15.