Adoption of rimegepant in Denmark: a register-based study on uptake, prescribing patterns and initiator characteristics

Abstract Background Rimegepant, an oral calcitonin gene-related peptide (CGRP) receptor antagonist, is the first drug within its class approved for both acute and preventive treatment of migraine. This study examines its uptake in Denmark. Methods Using nationwide healthcare registry data, we analyz...

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Main Authors: Lanfranco Pellesi, Thien Phu Do, Martin Thomsen Ernst, Jesper Hallas, Anton Pottegård
Format: Article
Language:English
Published: BMC 2025-04-01
Series:The Journal of Headache and Pain
Subjects:
Online Access:https://doi.org/10.1186/s10194-025-02028-w
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author Lanfranco Pellesi
Thien Phu Do
Martin Thomsen Ernst
Jesper Hallas
Anton Pottegård
author_facet Lanfranco Pellesi
Thien Phu Do
Martin Thomsen Ernst
Jesper Hallas
Anton Pottegård
author_sort Lanfranco Pellesi
collection DOAJ
description Abstract Background Rimegepant, an oral calcitonin gene-related peptide (CGRP) receptor antagonist, is the first drug within its class approved for both acute and preventive treatment of migraine. This study examines its uptake in Denmark. Methods Using nationwide healthcare registry data, we analyze trends in rimegepant prescriptions from its introduction in October 2022 to December 2024. Parameters assessed include demographic and clinical characteristics of users, temporal trends in drug use, treatment adherence, and concomitant use of other migraine therapies. Results By December 2024, over 140,000 defined daily doses (DDDs) of rimegepant had been dispensed in Denmark, primarily among females (88%), with a users’ median age of 45 years. Most initiators had prior experience with triptans (79%) or NSAIDs (38%) for migraine treatment and 69% met criteria for medication overuse before initiation. Concomitant use of triptans (63%) and NSAIDs (17%) remained common, but a substantial decline in the overuse of acute headache medications was observed after rimegepant initiation. Early discontinuation was very common, with 45% of initiators filling only one prescription. Among the 55% who continued treatment, the most substantial drop occurred within the first 90 days, followed by a more gradual decrease over time. Conclusions The study highlights the rapid uptake of rimegepant in Denmark, especially among middle-aged females with a history of triptan use and medication overuse. While rimegepant was associated with a reduction in acute medication overuse, early discontinuation rates suggest barriers to sustained use, potentially influenced by cost, efficacy, or patient preferences. There is a need for strategies to optimize long-term adherence and access to rimegepant in clinical practice.
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spelling doaj-art-d7f85b2550ea4eb09fce88e5c13bcb002025-08-20T02:17:48ZengBMCThe Journal of Headache and Pain1129-23772025-04-012611910.1186/s10194-025-02028-wAdoption of rimegepant in Denmark: a register-based study on uptake, prescribing patterns and initiator characteristicsLanfranco Pellesi0Thien Phu Do1Martin Thomsen Ernst2Jesper Hallas3Anton Pottegård4Clinical Pharmacology, Pharmacy and Environmental Medicine, Department of Public Health, University of Southern DenmarkDepartment of Neurology, Danish Headache Center, Copenhagen University Hospital - RigshospitaletClinical Pharmacology, Pharmacy and Environmental Medicine, Department of Public Health, University of Southern DenmarkClinical Pharmacology, Pharmacy and Environmental Medicine, Department of Public Health, University of Southern DenmarkClinical Pharmacology, Pharmacy and Environmental Medicine, Department of Public Health, University of Southern DenmarkAbstract Background Rimegepant, an oral calcitonin gene-related peptide (CGRP) receptor antagonist, is the first drug within its class approved for both acute and preventive treatment of migraine. This study examines its uptake in Denmark. Methods Using nationwide healthcare registry data, we analyze trends in rimegepant prescriptions from its introduction in October 2022 to December 2024. Parameters assessed include demographic and clinical characteristics of users, temporal trends in drug use, treatment adherence, and concomitant use of other migraine therapies. Results By December 2024, over 140,000 defined daily doses (DDDs) of rimegepant had been dispensed in Denmark, primarily among females (88%), with a users’ median age of 45 years. Most initiators had prior experience with triptans (79%) or NSAIDs (38%) for migraine treatment and 69% met criteria for medication overuse before initiation. Concomitant use of triptans (63%) and NSAIDs (17%) remained common, but a substantial decline in the overuse of acute headache medications was observed after rimegepant initiation. Early discontinuation was very common, with 45% of initiators filling only one prescription. Among the 55% who continued treatment, the most substantial drop occurred within the first 90 days, followed by a more gradual decrease over time. Conclusions The study highlights the rapid uptake of rimegepant in Denmark, especially among middle-aged females with a history of triptan use and medication overuse. While rimegepant was associated with a reduction in acute medication overuse, early discontinuation rates suggest barriers to sustained use, potentially influenced by cost, efficacy, or patient preferences. There is a need for strategies to optimize long-term adherence and access to rimegepant in clinical practice.https://doi.org/10.1186/s10194-025-02028-wCGRPDrug utilizationHeadacheMedication overuse headachePainTreatment patterns
spellingShingle Lanfranco Pellesi
Thien Phu Do
Martin Thomsen Ernst
Jesper Hallas
Anton Pottegård
Adoption of rimegepant in Denmark: a register-based study on uptake, prescribing patterns and initiator characteristics
The Journal of Headache and Pain
CGRP
Drug utilization
Headache
Medication overuse headache
Pain
Treatment patterns
title Adoption of rimegepant in Denmark: a register-based study on uptake, prescribing patterns and initiator characteristics
title_full Adoption of rimegepant in Denmark: a register-based study on uptake, prescribing patterns and initiator characteristics
title_fullStr Adoption of rimegepant in Denmark: a register-based study on uptake, prescribing patterns and initiator characteristics
title_full_unstemmed Adoption of rimegepant in Denmark: a register-based study on uptake, prescribing patterns and initiator characteristics
title_short Adoption of rimegepant in Denmark: a register-based study on uptake, prescribing patterns and initiator characteristics
title_sort adoption of rimegepant in denmark a register based study on uptake prescribing patterns and initiator characteristics
topic CGRP
Drug utilization
Headache
Medication overuse headache
Pain
Treatment patterns
url https://doi.org/10.1186/s10194-025-02028-w
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