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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

Status
Completed
Phases
Phase 3
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT04574362
Enrollment
1648
Registered
2020-10-05
Start date
2020-10-22
Completion date
2021-12-16
Last updated
2023-12-14

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Acute Migraine

Keywords

Migraine

Brief summary

This trial is to determine whether BHV3000 (rimegepant) 75mg is safe and effictive as a treatment for acute migraine in Chinese and Korean patients

Detailed description

Biohaven Pharmaceuticals, Inc. is the agent for BioShin Limited, the sponsor of the studies in China and Korea.

Interventions

DRUGRimegepant

One 75mg orally disintegrating tablet

DRUGPlacebo

Matching placebo

Sponsors

BioShin Limited
CollaboratorINDUSTRY
Pfizer
Lead SponsorINDUSTRY

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)

Eligibility

Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No

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: 1. Migraine attacks present for more than 1 year with the age of onset prior to 50 years of age 2. Migraine attacks, on average, lasting about 4-72 hours if untreated 3. Not more than 8 attacks of moderate to severe intensity per month within the last 3 months 4. 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 5. 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. 6. 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. 7. Subjects with contraindications for use of triptans may be included provided they meet all other study entry criteria. Key

Exclusion criteria

1. Subject with a history of HIV disease 2. 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 3. 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) 4. 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. 5. 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 6. 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. 7. 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. 8. 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 9. Participation in any other investigational clinical trial while participating in this clinical trial

Design outcomes

Primary

MeasureTime frameDescription
Percentage of Participants Who Had Freedom From Pain at 2 Hours Post-dose2 hours post-dosePain 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.
Percentage of Participants Who Had Freedom From Most Bothersome Symptoms (MBS) at 2 Hours Post-dose2 hours post-doseMBS 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.

Secondary

MeasureTime frameDescription
Percentage of Participants Who Used Rescue Medication Within 24 Hours Post-dose24 hours post-dosePercentage 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.
Percentage of Participants Who Sustained Pain Freedom From 2 to 24 Hours Post-dose2 to 24 hours post-dosePain 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.
Percentage of Participants Who Sustained Pain Freedom From 2 to 48 Hours Post-dose2 to 48 hours post-dosePain 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.
Percentage of Participants With Pain Relief at 2 Hours Post-dose2 hours post-dosePain 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.
Percentage of Participants Who Had Freedom From MBS at 15, 30, 45, 60 and 90 Minutes Post-dose15, 30, 45, 60 and 90 minutes post-doseMBS 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.
Percentage of Participants With Pain Relapse2 Hours to 48 Hours Post-dosePain 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.
Percentage of Participants Who Had Freedom From Pain at 15, 30, 45, 60 and 90 Minutes Post-dose15, 30, 45, 60 and 90 minutes post-dosePain 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.
Percentage of Participants Who Functioned Normally at 2 Hours Post-dose2 hours post-doseParticipants 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.

Countries

China, South Korea

Participant flow

Recruitment details

Overall, 1648 participants were enrolled and screened. A total of 217 participants were screen failures. Only 1431 participants were randomized. Out of 1431 participants, only 1342 participants were treated.

Pre-assignment details

Participants were dispensed with 1 dose of study drug at randomization (baseline). Participants were required to administer pre-dispensed study drug only when the participants developed a migraine headache of moderate or severe intensity and completed all required migraine assessment questions in the electronic diary (eDiary), including their current most bothersome migraine symptom within 45 days of randomization.

Participants by arm

ArmCount
Rimegepant 75 mg
Participants were randomized to receive 1 orally disintegrating tablet of rimegepant 75 mg. Participants were followed up to for 7 days post-dose.
668
Placebo
Participants were randomized to receive placebo matched to rimegepant. Participants were followed up to 7 days post-dose.
674
Total1,342

Withdrawals & dropouts

PeriodReasonFG000FG001
Overall StudyAdverse Event11
Overall StudyCOVID-1901
Overall StudyOther05
Overall StudyParticipant anxious to go to their hometown and withdrew from study10
Overall StudyParticipant quit early because of business trip10
Overall StudyParticipant refused the visit10
Overall StudyParticipant refused to come to the hospital10
Overall StudyWithdrawal by Subject24

Baseline characteristics

CharacteristicRimegepant 75 mgPlaceboTotal
Age, Continuous37.8 Years
STANDARD_DEVIATION 10.13
37.7 Years
STANDARD_DEVIATION 10.7
37.8 Years
STANDARD_DEVIATION 10.42
Race and Ethnicity Not Collected0 Participants
Sex: Female, Male
Female
526 Participants563 Participants1089 Participants
Sex: Female, Male
Male
142 Participants111 Participants253 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
deaths
Total, all-cause mortality
0 / 6680 / 674
other
Total, other adverse events
92 / 66894 / 674
serious
Total, serious adverse events
1 / 6682 / 674

Outcome results

Primary

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.

Time frame: 2 hours post-dose

Population: mITT participants included all randomized participants who took study drug, had a migraine of moderate or severe intensity at the time of treatment, and provided at least 1 post-treatment efficacy data point.

ArmMeasureValue (NUMBER)
Rimegepant 75 mgPercentage of Participants Who Had Freedom From Most Bothersome Symptoms (MBS) at 2 Hours Post-dose50.5 Percentage of participants
PlaceboPercentage of Participants Who Had Freedom From Most Bothersome Symptoms (MBS) at 2 Hours Post-dose35.8 Percentage of participants
p-value: <0.000195% CI: [9.6, 20]Cochran-Mantel-Haenszel
Primary

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.

Time frame: 2 hours post-dose

Population: Modified intent to treat (mITT) participants included all randomized participants who took study drug, had a migraine of moderate or severe intensity at the time of treatment, and provided at least 1 post-treatment efficacy data point.

ArmMeasureValue (NUMBER)
Rimegepant 75 mgPercentage of Participants Who Had Freedom From Pain at 2 Hours Post-dose19.8 Percentage of participants
PlaceboPercentage of Participants Who Had Freedom From Pain at 2 Hours Post-dose10.7 Percentage of participants
p-value: <0.000195% CI: [5.4, 13]Cochran-Mantel-Haenszel
Secondary

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.

Time frame: 2 hours post-dose

Population: mITT participants included all randomized participants who took study drug, had a migraine of moderate or severe intensity at the time of treatment, and provided at least 1 post-treatment efficacy data point. Here, Overall Number of Participants Analyzed signifies participants evaluable for this outcome measure.

ArmMeasureValue (NUMBER)
Rimegepant 75 mgPercentage of Participants Who Functioned Normally at 2 Hours Post-dose40.7 Percentage of participants
PlaceboPercentage of Participants Who Functioned Normally at 2 Hours Post-dose23.8 Percentage of participants
p-value: <0.000195% CI: [11.4, 22.3]Cochran-Mantel-Haenszel
Secondary

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.

Time frame: 15, 30, 45, 60 and 90 minutes post-dose

Population: mITT participants included all randomized participants who took study drug, had a migraine of moderate or severe intensity at the time of treatment, and provided at least 1 post-treatment efficacy data point.

ArmMeasureGroupValue (NUMBER)
Rimegepant 75 mgPercentage of Participants Who Had Freedom From MBS at 15, 30, 45, 60 and 90 Minutes Post-dose30 minutes post-dose16.8 Percentage of participants
Rimegepant 75 mgPercentage of Participants Who Had Freedom From MBS at 15, 30, 45, 60 and 90 Minutes Post-dose60 minutes post-dose31.1 Percentage of participants
Rimegepant 75 mgPercentage of Participants Who Had Freedom From MBS at 15, 30, 45, 60 and 90 Minutes Post-dose45 minutes post-dose24.2 Percentage of participants
Rimegepant 75 mgPercentage of Participants Who Had Freedom From MBS at 15, 30, 45, 60 and 90 Minutes Post-dose90 minutes post-dose41.4 Percentage of participants
Rimegepant 75 mgPercentage of Participants Who Had Freedom From MBS at 15, 30, 45, 60 and 90 Minutes Post-dose15 minutes post-dose10.2 Percentage of participants
PlaceboPercentage of Participants Who Had Freedom From MBS at 15, 30, 45, 60 and 90 Minutes Post-dose90 minutes post-dose31.8 Percentage of participants
PlaceboPercentage of Participants Who Had Freedom From MBS at 15, 30, 45, 60 and 90 Minutes Post-dose15 minutes post-dose11.1 Percentage of participants
PlaceboPercentage of Participants Who Had Freedom From MBS at 15, 30, 45, 60 and 90 Minutes Post-dose30 minutes post-dose14.8 Percentage of participants
PlaceboPercentage of Participants Who Had Freedom From MBS at 15, 30, 45, 60 and 90 Minutes Post-dose45 minutes post-dose19.9 Percentage of participants
PlaceboPercentage of Participants Who Had Freedom From MBS at 15, 30, 45, 60 and 90 Minutes Post-dose60 minutes post-dose24.8 Percentage of participants
Comparison: 15 minutes post-dosep-value: 0.680995% CI: [-3.9, 2.5]Cochran-Mantel-Haenszel
Comparison: 30 minutes post-dosep-value: 0.258695% CI: [-1.6, 6]Cochran-Mantel-Haenszel
Comparison: 45 minutes post-dosep-value: 0.042195% CI: [0.2, 8.8]Cochran-Mantel-Haenszel
Comparison: 60 minutes post-dosep-value: 0.006695% CI: [1.8, 11.3]Cochran-Mantel-Haenszel
Comparison: 90 minutes post-dosep-value: 0.000295% CI: [4.8, 14.9]Cochran-Mantel-Haenszel
Secondary

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.

Time frame: 15, 30, 45, 60 and 90 minutes post-dose

Population: mITT participants included all randomized participants who took study drug, had a migraine of moderate or severe intensity at the time of treatment, and provided at least 1 post-treatment efficacy data point.

ArmMeasureGroupValue (NUMBER)
Rimegepant 75 mgPercentage of Participants Who Had Freedom From Pain at 15, 30, 45, 60 and 90 Minutes Post-dose30 minutes post-dose1.1 Percentage of participants
Rimegepant 75 mgPercentage of Participants Who Had Freedom From Pain at 15, 30, 45, 60 and 90 Minutes Post-dose60 minutes post-dose6.8 Percentage of participants
Rimegepant 75 mgPercentage of Participants Who Had Freedom From Pain at 15, 30, 45, 60 and 90 Minutes Post-dose45 minutes post-dose3.3 Percentage of participants
Rimegepant 75 mgPercentage of Participants Who Had Freedom From Pain at 15, 30, 45, 60 and 90 Minutes Post-dose90 minutes post-dose12.3 Percentage of participants
Rimegepant 75 mgPercentage of Participants Who Had Freedom From Pain at 15, 30, 45, 60 and 90 Minutes Post-dose15 minutes post-dose0.8 Percentage of participants
PlaceboPercentage of Participants Who Had Freedom From Pain at 15, 30, 45, 60 and 90 Minutes Post-dose90 minutes post-dose7.1 Percentage of participants
PlaceboPercentage of Participants Who Had Freedom From Pain at 15, 30, 45, 60 and 90 Minutes Post-dose15 minutes post-dose1.5 Percentage of participants
PlaceboPercentage of Participants Who Had Freedom From Pain at 15, 30, 45, 60 and 90 Minutes Post-dose30 minutes post-dose1.0 Percentage of participants
PlaceboPercentage of Participants Who Had Freedom From Pain at 15, 30, 45, 60 and 90 Minutes Post-dose45 minutes post-dose2.2 Percentage of participants
PlaceboPercentage of Participants Who Had Freedom From Pain at 15, 30, 45, 60 and 90 Minutes Post-dose60 minutes post-dose4.5 Percentage of participants
Comparison: 15 minutes post-dosep-value: 0.205795% CI: [-1.9, 0.4]Cochran-Mantel-Haenszel
Comparison: 30 minutes post-dosep-value: 0.970295% CI: [-1.1, 1.1]Cochran-Mantel-Haenszel
Comparison: 45 minutes post-dosep-value: 0.241995% CI: [-0.7, 2.8]Cochran-Mantel-Haenszel
Comparison: 60 minutes post-dosep-value: 0.059795% CI: [-0.1, 4.8]Cochran-Mantel-Haenszel
Comparison: 90 minutes post-dosep-value: 0.001295% CI: [2.1, 8.4]Cochran-Mantel-Haenszel
Secondary

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.

Time frame: 2 to 24 hours post-dose

Population: mITT participants included all randomized participants who took study drug, had a migraine of moderate or severe intensity at the time of treatment, and provided at least 1 post-treatment efficacy data point.

ArmMeasureValue (NUMBER)
Rimegepant 75 mgPercentage of Participants Who Sustained Pain Freedom From 2 to 24 Hours Post-dose15.6 Percentage of participants
PlaceboPercentage of Participants Who Sustained Pain Freedom From 2 to 24 Hours Post-dose7.9 Percentage of participants
p-value: <0.000195% CI: [4.3, 11.2]Cochran-Mantel-Haenszel
Secondary

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.

Time frame: 2 to 48 hours post-dose

Population: mITT participants included all randomized participants who took study drug, had a migraine of moderate or severe intensity at the time of treatment, and provided at least 1 post-treatment efficacy data point.

ArmMeasureValue (NUMBER)
Rimegepant 75 mgPercentage of Participants Who Sustained Pain Freedom From 2 to 48 Hours Post-dose14.9 Percentage of participants
PlaceboPercentage of Participants Who Sustained Pain Freedom From 2 to 48 Hours Post-dose7.1 Percentage of participants
p-value: <0.000195% CI: [4.4, 11]Cochran-Mantel-Haenszel
Secondary

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.

Time frame: 24 hours post-dose

Population: mITT participants included all randomized participants who took study drug, had a migraine of moderate or severe intensity at the time of treatment, and provided at least 1 post-treatment efficacy data point.

ArmMeasureValue (NUMBER)
Rimegepant 75 mgPercentage of Participants Who Used Rescue Medication Within 24 Hours Post-dose8.4 Percentage of participants
PlaceboPercentage of Participants Who Used Rescue Medication Within 24 Hours Post-dose20.0 Percentage of participants
p-value: <0.000195% CI: [-15, -8]Cochran-Mantel-Haenszel
Secondary

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.

Time frame: 2 Hours to 48 Hours Post-dose

Population: mITT participants included all randomized participants who took study drug, had a migraine of moderate or severe intensity at the time of treatment, and provided at least 1 post-treatment efficacy data point. Here, Overall Number of Participants Analyzed signifies participants evaluable for this outcome measure.

ArmMeasureValue (NUMBER)
Rimegepant 75 mgPercentage of Participants With Pain Relapse25.0 Percentage of participants
PlaceboPercentage of Participants With Pain Relapse33.3 Percentage of participants
p-value: 0.114895% CI: [-23.5, 2.8]Cochran-Mantel-Haenszel
Secondary

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.

Time frame: 2 hours post-dose

Population: mITT participants included all randomized participants who took study drug, had a migraine of moderate or severe intensity at the time of treatment, and provided at least 1 post-treatment efficacy data point.

ArmMeasureValue (NUMBER)
Rimegepant 75 mgPercentage of Participants With Pain Relief at 2 Hours Post-dose66.5 Percentage of participants
PlaceboPercentage of Participants With Pain Relief at 2 Hours Post-dose48.5 Percentage of participants
p-value: <0.000195% CI: [13, 23.3]Cochran-Mantel-Haenszel

Source: ClinicalTrials.gov · Data processed: Feb 11, 2026