Real-world evidence
Nurtec® (rimegepant) in real-world clinical practice
What HeAD-US, CONFIDENCE, GAINER, AAN 2025 materials and a persistence analysis showed — in short cards.
4+ studies
observational, registry and claims data
1570 + 416 + 103 + 9909×2
patients analysed
2/10
Why real-world evidence
Four clinical questions RCTs leave open
Will it work again?
→ CONFIDENCE
What about difficult patients?
→ GAINER
What if the dose is late?
→ GAINER
Will patients stay on therapy?
→ US claims analysis
3/10
HeAD-US · US · n=1570
Gepants vs triptans head-to-head
Pain relief at 24 h (adjusted probabilities):
aOR 1.36
24-h relief — gepant advantage
aOR 1.04
pain freedom 2 h — comparable
Even though the gepant group was «sicker» at baseline (chronic migraine 38% vs 28%).
4/10
AAN 2025 · Adelphi DSP + NHWS
Optimised acute treatment
Adelphi Migraine DSP (US, 2022), per mTOQ-6.
71.4%
satisfaction on rimegepant (NHWS)
52%
on triptans (p<0.001)
5/10
CONFIDENCE · US · 2169 attacks
«Will it work again?» — yes
Meaningful pain relief ≤2 h, % of attacks (attacks 1–4):
65.1
1st
61.2
2nd
61.6
3rd
64
4th
61.3%
of all attacks — relief ≤2 h
68.4%
satisfaction with treatment
84% on preventives, 89% had stopped ≥1 triptan — and outcomes hold steady from attack to attack.
6/10
CONFIDENCE · within patient
2 in 3
patients had meaningful pain relief in ≥2 of their first 3 attacks
74% were satisfied with treatment in ≥2 of 3 attacks. A predictable result supports adherence.
7/10
GAINER · Italy · 16 headache centres
80.4%
complete headache freedom at 2 h — when rimegepant was taken within the first 60 minutes of the attack
p=0.032 · effect independent of prior triptan response and attack severity
8/10
GAINER · the patient voice
Difficult-to-treat patients rated it
mean 2.7 failed preventive classes
57% absent/poor triptan response
chronic migraine — 24%
7.1/10
global satisfaction
48.3%
«better than triptans» (+24% «comparable»)
85.4%
tolerability good/excellent
AEs in 15.5% — all mild and self-limiting; only 19.4% needed rescue medication.
9/10
US claims data · PSM 9909×9909
Patients stay on therapy
Still on treatment at 12 months:
OR 2.72
2.7-fold higher odds of persisting (95% CI 2.56–2.90), consistent across subgroups
10/10
Bottom line
RWE complements RCTs: consistent response, difficult patients, late dosing, persistence
✓ satisfaction 68–74% (CONFIDENCE), 7.1/10 (GAINER)
✓ consistency from attack to attack
✓ 80.4% pain freedom with early intake (GAINER)
✓ persistence 75.8% vs 53.5% at 12 months
Full interactive version with charts, podcast and PDF —
docs.mdwrt.app
docs.mdwrt.app