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Evaluating acute migraine therapies: ICER

March 11, 2020

…elated peptide (CGRP) receptor antagonists (ubrogepant, rimegepant) and a 5-HT-1F receptor agonist (lasmiditan). All three drugs have recently received FDA approval. None of the therapies is listed by Health Canada as being in review. An ICER panel voted unanimously that all three oral migraine drugs provide a net health benefit compared to placebo. However, the data were insufficient to show superiority over triptans for acute migraine. All panel…

Natalizumab use in late pregnancy

February 19, 2020

…al. JAMA Neurol 2014;71:891-895). In that study, 10 of 13 infants had mild-to-moderate hematologic changes, including anemia and thrombocytopenia. Clinical monitoring by a pediatrician was recommended to evaluate potential complications of anemia and thrombocytopenia. Animal studies have reported that natalizumab (up to 30 mg/kg IV every other day) appears to cross the placenta primarily during the third trimester but does not alter fetal develop…

New drug approvals in 2020

February 5, 2020

…t, a phase III trial reported that 21% of acute migraine patients were pain-free with rimegepant (vs. placebo 11%) and 35% were free of their most bothersome symptom (vs. placebo 27%) at two hours post-dosing (Croop et al. Lancet 2019;394:737-745). Biohaven is currently enrolling patients in a phase III trial of rimegepant for migraine prophylaxis. Psychiatry Esketamine (Janssen): This N-methyl D-aspartate (NMDA) receptor blocker (Spravato) is cur…