ArticleHeadache2026
Reduction of opioid and barbiturate use following initiation of rimegepant for migraine in the United States.
Article in Headache, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
1 citing paper in PubMed.
- Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
Abstract
objectiveThe primary objective of this study was to evaluate opioid and barbiturate utilization before and after the first prescription of the calcitonin gene-related peptide receptor antagonist rimegepant in individuals with migraine.
backgroundAlthough not recommended in migraine treatment guidelines, opioids and barbiturates are often prescribed for the acute treatment of migraine, despite the risks of dependence and harm. Initiating a migraine-specific acute treatment might reduce the use of opioids and barbiturates.
methodsThis retrospective cohort study among adults in the United States with migraine and a first prescription for rimegepant (fill quantity of eight tablets, indicative of acute treatment) was based on administrative claims data from the IQVIA PharMetrics Plus longitudinal health plan database (September 1, 2019, through March 31, 2023). For opioids and butalbital (separately), number of prescription fills and average dispensed amounts (as morphine milligram equivalents [MME] and milligrams [mg], respectively) were assessed in the 180 days preceding (pre-index) and the 180 days following (post-index) rimegepant initiation. Subgroup analyses included individuals using ≥ 1 preventive treatment, and individuals with problematic opioid use (≥ 3 opioid prescriptions and/or MME in the fourth quartile).
resultsAmong 1928 opioid users, rimegepant initiation was associated with a significant difference in opioid prescription fills (median [interquartile range (IQR)] 2 [1-5] pre-index vs. 1 [0-5] post-index, p < 0.001) and average dispensed MME (25 [17.5-37.5] pre-index vs. 14 [0-30] post-index, p < 0.001), and 740 users (38.4%) discontinued opioids. Among 873 butalbital users, rimegepant initiation was associated with a significant difference in butalbital prescription fills (median [IQR] 2 [1-4] pre-index vs. 1 [0-3] post-index, p < 0.001) and average dispensed mg (200 [100-300] pre-index vs. 25 [0-187.5] post-index, p < 0.001), and 422 users (48.3%) discontinued opioids. Rimegepant initiation was associated with reduction of opioid and butalbital utilization in the subgroups using preventive treatment, and reduction of opioid utilization in the subgroup with problematic opioid use.
conclusionsRimegepant initiation was associated with reductions in utilization of opioids and butalbital, including in individuals using preventive treatment for migraine, and with reduction of opioid utilization in individuals with problematic opioid use.
Indexed as
Identifiers
What Socratic holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.