- The FDA approved the drug called Reyvow.
- Patients who took the newly approved drug experienced migraine resolution in just 2 hours.
- Migraine symptoms include nausea, vomiting, intense throbbing, and sensitivity to light and sound.
More than 1 in 10 Americans deal with migraine in the United States. The condition affects 39 million men, women, and children in the United States and 1 billion worldwide, the Migraine Research Foundation reports.
Now there’s a new drug that may help.
The Food and Drug Administration (FDA) recently
The drug treats migraine with or without aura — a common sensory phenomenon or visual disturbance that can accompany migraine.
Reyvow was tested in two randomized, double-blind, placebo-controlled clinical trials. The trials involved 3,177 adults with a history of migraine. Of them, 22 percent were taking a preventive medication for migraine. In both trials, the percentage of patients whose pain and other symptoms resolved within 2 hours of taking the medication were significantly greater among patients receiving Reyvow compared to those who took a placebo.
Side effects can include driving impairments, so patients shouldn’t drive or operate machinery for at least 8 hours after taking Reyvow. Other side effects include dizziness, fatigue, a burning or prickling sensation in the skin known as paresthesia, and sedation.
Reyvow is made by Eli Lilly and Company.
Dr. Nina Riggins, a neurologist specializing in headache medicine from the University of California, San Francisco, said the introduction of Reyvow is a significant breakthrough because it’s a new class of medications known as ditans.
This kind of medication works similar to another type of medication called triptans, a class of medications to treat migraine that came out in the 1990s and helped with acute migraine.
But triptans narrowed blood vessels, so they weren’t a good choice for patients with cardiac or stroke risk factors. Common triptans include Imitrex, Zomig, and Maxalt.
Experts say that ditans work similarly to triptans but do not have the cardiovascular effects.
“It will allow us to use it for people with migraine who cannot take triptans due to concerns for stroke or heart attack,” Riggins explained.
Dr. Deena Kuruvilla, an assistant professor at Yale School of Medicine agreed that Reyvow is a “game-changer” because it works on different receptors than triptans.
“Also, many of our patients with migraine do not respond to triptans, so this will be another option for them,” Kuruvilla added.
Gregory Dussor, PhD, an associate professor and migraine researcher at the University of Texas at Dallas, said without any cardiac effects, this drug could help more patients.
“Reyvow doesn’t have these issues, so is a potential option in a larger number of patients,” said Dussor.
The Drug Enforcement Administration (DEA) still has to approve Reyvow, so it can’t yet be prescribed, Riggins said.
But this isn’t the only potential breakthrough for migraine treatment.
Other migraine treatments on the horizon include small molecule calcitonin gene-related peptide (CGRP) receptor antagonists, another pathway that’s been useful in treating migraine.
“We are looking forward to see if FDA approval is granted to [eptinezumab] the first IV form of CGRP antibody,” Riggins noted.
Ubrogepant will be the first approved oral CGRP receptor antagonist for the acute treatment of migraine and will be produced by Allergan. It was already approved by the FDA.
Drugs such as Aimovig, Ajovy, and Emgality that were recently approved are typically only given to patients with frequent migraine attacks. CGRP-targeting drugs will be better for patients with less frequent attacks, said Dussor.
In addition to drugs, neuromodulation devices are being developed for prevention and treatment. A smartphone-controlled wearable device will be available once approved by the FDA.
“We are learning more about migraine pathophysiology, which allows for more targeted therapeutic options in the future,” Riggins said. Researchers are also discovering a lot about integrative approaches that include meditation, lifestyle modifications, and behavioral therapy to treat migraine.