New hope for the significant number of people who live with the pain and disability caused by migraine, and with the uncertainty of the arrival of the next crisis. This neurological disease affects 12% of the Spanish population, 4 million people, of whom 80% are women, mainly between 20 and 40 years old. According to the WHO, there are more than 1,000 million affected worldwide and it is one of the ten most disabling pathologies, since 90% of patients cannot work or do activities of daily life when they have an attack.
Despite the high incidence, almost 54% of those affected in Spain say that they have not found a useful solution to withstand the effects of the chronic pathology. In this context, the country’s first authorized medicine has just been marketed both for the acute treatment of migraine with or without aura and for the preventive treatment of episodic migraine in adults who have at least four attacks per month.
Vydura, the commercial name of the active ingredient rimegepant, represents an advance for the therapeutic approach to migraine both on a palliative and preventive scale and was authorized by the European Commission in April 2022. In Spain, the Interministerial Commission of Preus de Medicaments approved the financing of the new therapy setting a price of 464.34 euros for each container of 16 tablets. Vydura requires a prescription and public funding does not extend to all patients. “The indication that is financed is that of prevention, with some limitations: patients who have between 8 and 14 migraine attacks per month, who have undergone at least three previous treatments without an adequate response for three months and have a prescription for a specialist will be able to access reimbursement from the National Health System”, José Chaves, medical director of Pfizer España, the manufacturer, explained yesterday. Patients who do not meet these conditions can access the medicine in pharmacy offices, but at the market price (29 euros for each pill) and always with a prescription.
The recommended dose for the acute treatment of migraine is one Vydura tablet, as needed, once a day. As for prevention, a dose every two days is recommended.
Rimegepant acts on the peptide pathway, related to the calcitonin gene. Around 20% of patients have no pain after two hours of administration in a crisis situation, according to pharmaceutical studies. With regard to prophylaxis (one pill every other day for 16 months), trials indicate an overall mean reduction of 6.2 migraine days per month in treated patients.
“It is an oral treatment that has a rapid onset of action, reduces pain in two hours or less and lasts up to 48 hours”, said Chaves, who emphasized the fact that it has very few side effects and they are not many serious
Jesús Porta-Etessam, president of the Spanish Society of Neurology, points out the misunderstanding and stigma around migraine: “The fact that it is a disease that goes through crises, when the patient does not have pain tends to have a supernormal life, that is to say, he makes a special effort to do everything he cannot do during the migraine”.
