Title

Safety and Efficacy Trial of BHV3000 (Rimegepant) 75 mg for the Acute Treatment of Migraine
BHV3000-310: Phase 3: Double-Blind, Randomized, Placebo Controlled, Safety and Efficacy Trial of BHV3000 (Rimegepant) 75 mg for the Acute Treatment of Migraine
  • Phase

    Phase 3
  • Study Type

    Interventional
  • Study Participants

    1648
This trial is to determine whether BHV3000 (rimegepant) 75mg is safe and effictive as a treatment for acute migraine in Chinese and Korean patients
Biohaven Pharmaceuticals, Inc. is the agent for BioShin Limited, the sponsor of the studies in China and Korea.
Study Started
Oct 22
2020
Primary Completion
Nov 24
2021
Study Completion
Dec 16
2021
Results Posted
Dec 14
2023
Last Update
Dec 14
2023

Drug Rimegepant

One 75mg orally disintegrating tablet

Drug Placebo

Matching placebo

Rimegepant 75mg Active Comparator

One 75mg oral disintegration tablet

Placebo Placebo Comparator

Matching placebo

Criteria

Inclusion Criteria:

Subject has at least 1 year history of migraines (with or without aura), consistent with a diagnosis according to the International Classification of Headache Disorder, 3rd Edition, Beta version including the following:

Migraine attacks present for more than 1 year with the age of onset prior to 50 years of age
Migraine attacks, on average, lasting about 4-72 hours if untreated
Not more than 8 attacks of moderate to severe intensity per month within the last 3 months
Consistent migraine headaches of at least 2 migraine headache attacks of moderate or severe intensity in each of the 3 months prior to the Screening Visit and maintains this requirement during the Screening period
Less than 15 days with headache (migraine or non-migraine) per month in each of the 3 months prior to the Screening Visit and maintains this requirement during the Screening Period.
Subjects on prophylactic migraine medication are permitted to remain on therapy provided they have been on a stable dose for at least 3 months prior to screening visit and the dose is not expected to change during the course of the study.
Subjects with contraindications for use of triptans may be included provided they meet all other study entry criteria.

Key Exclusion Criteria:

Subject with a history of HIV disease
Subject history with current evidence of uncontrolled, unstable or recently diagnosed cardiovascular disease, such as ischemic heart disease, coronary artery vasospasm, and cerebral ischemia. subjects with Myocardial Infarction (MI), Acute Coronary Syndrome (ACS), Percutaneous Coronary Intervention (PCI), cardiac surgery, stroke or transient ischemic attack (TIA) during the 6 months prior to screening
Uncontrolled hypertension (high blood pressure), or uncontrolled diabetes (however subjects can be included who have stable hypertension and/or diabetes for at least 3 months prior to being enrolled)
Subject has a current diagnosis of major depression, other pain syndromes, psychiatric conditions (e.g., schizophrenia), dementia, or significant neurological disorders (other than migraine) that, in the Investigator's opinion might interfere with study assessments.
Subject has a history of gastric, or small intestinal surgery (including Gastric Bypass, Gastric Banding, Gastric Sleeve, Gastric Balloon, etc.), or has disease that causes malabsorption
The subject has a history of current or evidence of any significant and/ or unstable medical conditions (e.g., history of congenital heart disease or arrhythmia, known suspected infection, hepatitis B or C, or cancer) that, in the investigator's opinion, would expose them to undue risk of a significant adverse event (AE) or interfere with assessments of safety or efficacy during the course of the trial.
History of, treatment for, or evidence of, alcohol or drug abuse within the past 12 months or subjects who have met DSM-V criteria for any significant substance use disorder within the past 12 months from the date of the screening visit.
Subjects are excluded if they have previously participated in any study of rimegepant or other experimental CGRP-antagonist study, or have been prescribed CGRP-antibodies within the last 6 months
Participation in any other investigational clinical trial while participating in this clinical trial

Summary

Rimegepant 75 mg

Placebo

All Events

Event Type Organ System Event Term Rimegepant 75 mg Placebo

Percentage of Participants Who Had Freedom From Most Bothersome Symptoms (MBS) at 2 Hours Post-dose

MBS included nausea, phonophobia or photophobia. MBS were measured using a binary scale as 0= absent, 1= present. Participants who had score of 0 (MBS absent) were considered to have freedom from MBS. Exact 95% CI was based on Clopper-Pearson method.

Rimegepant 75 mg

50.5
Percentage of participants
95% Confidence Interval: 46.6 to 54.3

Placebo

35.8
Percentage of participants
95% Confidence Interval: 32.1 to 39.5

Percentage of Participants Who Had Freedom From Pain at 2 Hours Post-dose

Pain was measured on a 4-point Likert scale, with following scores: 0= none, 1= mild, 2= moderate, 3= severe. Participants with score of 0 (no pain) were considered to have freedom from pain. Exact 95 percent (%) confidence interval (CI) was based on Clopper-Pearson method.

Rimegepant 75 mg

19.8
Percentage of participants
95% Confidence Interval: 16.9 to 23.1

Placebo

10.7
Percentage of participants
95% Confidence Interval: 8.5 to 13.3

Percentage of Participants Who Functioned Normally at 2 Hours Post-dose

Participants rated the level of disability they perceived as a result of their migraine in performing normal actions using following level of severity: normal function, mild impairment, severe impairment, or required bedrest. This outcome measure was analyzed only among those participants who reported any impairment at baseline. Percentage of participants with a response of "normal function" at the 2 hours post-dose were reported in this outcome measure.

Rimegepant 75 mg

40.7
Percentage of participants
95% Confidence Interval: 36.6 to 45.0

Placebo

23.8
Percentage of participants
95% Confidence Interval: 20.3 to 27.6

Percentage of Participants Who Sustained Pain Freedom From 2 to 24 Hours Post-dose

Pain was measured on a 4-point Likert scale, with following scores: 0= none, 1= mild, 2= moderate, 3= severe. Participants with score of 0 (with no pain) through 2 to 24 hours post-dose were considered to have sustained pain freedom. Exact 95% CI was based on Clopper-Pearson method.

Rimegepant 75 mg

15.6
Percentage of participants
95% Confidence Interval: 12.9 to 18.6

Placebo

7.9
Percentage of participants
95% Confidence Interval: 5.9 to 10.2

Percentage of Participants Who Sustained Pain Freedom From 2 to 48 Hours Post-dose

Pain was measured on a 4-point Likert scale, with following scores: 0= none, 1= mild, 2= moderate, 3= severe. Participants with score of 0 (with no pain) through 2 to 48 hours post-dose were considered to have sustained pain freedom. Exact 95% CI was based on Clopper-Pearson method.

Rimegepant 75 mg

14.9
Percentage of participants
95% Confidence Interval: 12.2 to 17.8

Placebo

7.1
Percentage of participants
95% Confidence Interval: 5.3 to 9.3

Percentage of Participants Who Had Freedom From Pain at 15, 30, 45, 60 and 90 Minutes Post-dose

Pain was measured on a 4-point Likert scale, with following scores: 0= none, 1= mild, 2= moderate, 3= severe. Percentage of participants who reported a pain level of moderate or severe just before taking study treatment and then reported a pain level of none at the specified timepoints. Exact 95% CI was based on Clopper-Pearson method.

Rimegepant 75 mg

15 minutes post-dose

0.8
Percentage of participants
95% Confidence Interval: 0.2 to 1.7

30 minutes post-dose

1.1
Percentage of participants
95% Confidence Interval: 0.4 to 2.2

45 minutes post-dose

3.3
Percentage of participants
95% Confidence Interval: 2.1 to 5.0

60 minutes post-dose

6.8
Percentage of participants
95% Confidence Interval: 5.0 to 8.9

90 minutes post-dose

12.3
Percentage of participants
95% Confidence Interval: 9.9 to 15.1

Placebo

15 minutes post-dose

1.5
Percentage of participants
95% Confidence Interval: 0.7 to 2.7

30 minutes post-dose

1.0
Percentage of participants
95% Confidence Interval: 0.4 to 2.1

45 minutes post-dose

2.2
Percentage of participants
95% Confidence Interval: 1.3 to 3.6

60 minutes post-dose

4.5
Percentage of participants
95% Confidence Interval: 3.0 to 6.3

90 minutes post-dose

7.1
Percentage of participants
95% Confidence Interval: 5.3 to 9.3

Percentage of Participants Who Had Freedom From MBS at 15, 30, 45, 60 and 90 Minutes Post-dose

MBS included nausea, phonophobia or photophobia. MBS were measured using a binary scale as 0= absent, 1= present. Participants who had score of 0 (MBS absent) were considered to have freedom from MBS at the specified timepoints. Exact 95% CI was based on Clopper-Pearson method.

Rimegepant 75 mg

15 minutes post-dose

10.2
Percentage of participants
95% Confidence Interval: 8.0 to 12.8

30 minutes post-dose

16.8
Percentage of participants
95% Confidence Interval: 14.1 to 19.9

45 minutes post-dose

24.2
Percentage of participants
95% Confidence Interval: 21.0 to 27.6

60 minutes post-dose

31.1
Percentage of participants
95% Confidence Interval: 27.6 to 34.7

90 minutes post-dose

41.4
Percentage of participants
95% Confidence Interval: 37.7 to 45.3

Placebo

15 minutes post-dose

11.1
Percentage of participants
95% Confidence Interval: 8.9 to 13.7

30 minutes post-dose

14.8
Percentage of participants
95% Confidence Interval: 12.2 to 17.7

45 minutes post-dose

19.9
Percentage of participants
95% Confidence Interval: 16.9 to 23.1

60 minutes post-dose

24.8
Percentage of participants
95% Confidence Interval: 21.6 to 28.2

90 minutes post-dose

31.8
Percentage of participants
95% Confidence Interval: 28.2 to 35.4

Percentage of Participants Who Used Rescue Medication Within 24 Hours Post-dose

Percentage of participants who used rescue medications within 24 hours of administration of study drug were reported in this outcome measure. Exact 95% CI was based on Clopper-Pearson method.

Rimegepant 75 mg

8.4
Percentage of participants
95% Confidence Interval: 6.4 to 10.8

Placebo

20.0
Percentage of participants
95% Confidence Interval: 17.1 to 23.3

Percentage of Participants With Pain Relapse

Pain was measured on a 4-point Likert scale, with following scores: 0= none, 1= mild, 2= moderate, 3= severe. This outcome measure was analyzed only in those participants who were pain free at 2 hours post-dose. Percentage of participants who were pain free at 2 hours post-dose and then had a migraine of any pain severity (score 2 or 3 on the 4-point scale) within 48 hours after administration of study drug were considered to have pain relapse. Exact 95% CI was based on Clopper-Pearson method.

Rimegepant 75 mg

25.0
Percentage of participants
95% Confidence Interval: 17.9 to 33.3

Placebo

33.3
Percentage of participants
95% Confidence Interval: 22.7 to 45.4

Percentage of Participants With Pain Relief at 2 Hours Post-dose

Pain was measured on a 4-point Likert scale, with following scores: 0= none, 1= mild, 2= moderate, 3= severe. Participants who reported a pain level of moderate or severe at baseline and then reported a pain level of none or mild at 2 hours post-dose, were considered to have pain relief. Exact 95% CI was based on Clopper-Pearson method.

Rimegepant 75 mg

66.5
Percentage of participants
95% Confidence Interval: 62.8 to 70.1

Placebo

48.5
Percentage of participants
95% Confidence Interval: 44.7 to 52.4

Total

1342
Participants

Age, Continuous

37.8
Years (Mean)
Standard Deviation: 10.42

Race and Ethnicity Not Collected

0
Participants

Sex: Female, Male

Overall Study

Rimegepant 75 Milligram (mg)

Placebo

Drop/Withdrawal Reasons

Rimegepant 75 Milligram (mg)

Placebo