Efficacy,Safety,and Acceptability Of Ubrogepant And Rimegepant For The Acute Treatment Of Migraine A Systematic Review And Network Meta-analysis

Background: Calcitonin gene-related peptide(CGRP)receptor antagonists have been developed as a therapeutic approach for migraine over 20 years.But in the clinical applicability and safety considerations,the previous research results were shelved.Recently,Rimegepant and Ubrogepant,two novel gepants,have completed phase III studies,and achieved positive results.The aim of this study was to compare the efficacy and acceptability between the two of them.Methods: We searched the Cochrane Central Register for Controlled Trials,Pub Med,Embase,Web of Science,Ovid Medline electronic databases and for relevant randomized controlled trials(RCTs)published until March 2020.The comparative efficacy and acceptability of the Rimegepant and Ubrogepant were assessed and further ranked based on the surface under the cumulative ranking curve(SUCRA)using the frequentist approach to the network meta-analysis.Results: Of 265 citations screened,6 studies with 5,934 participants were finally pooled in the network meta-analysis.For efficacy,Ubrogepant and Rimegepant were significantly more effective than placebo with respect to pain freedom at 2 hours and absence of the most bothersome symptoms associated with migraine at 2 hours.For safety,Ubrogepant 100 mg demonstrated a higher incidence of any-adverse-event and treatment-related AEs compared with placebo.In head to head studies,Ubrogepant50 mg performed equally well compared to Rimegepant 75 mg.Conclusion: Ubrogepant 50 mg performs equally well compared to Rimegepant 75 mg when used for acute treatment of migraine,and could be used for acute treatment of migraine,especially for patients who cannot tolerate triptans.