ReviewPain management2025
Head-to-head relief: ubrogepant, rimegepant, and zavegepant in migraine treatment.
Review in Pain management, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 2 of them syntheses that pooled it.
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
16 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Rimegepant for the acute treatment of migraine: a systematic review and meta-analysis.The journal of headache and pain · 2026Pooled it
- Cost-effectiveness of abortive and preventative treatments in patients with migraine: a systematic review.European journal of clinical pharmacology · 2025Pooled it
- Effectiveness of Rimegepant for the Acute Treatment of Migraine Among Participants Using Different Types of Preventive Therapy: Analyses from CONFIDENCE.Neurology and therapy · 2026Article
- Quality by design based development and optimization of a thermoreversible in situ intranasal gel of zavegepant for nose to brain delivery in migraine therapy.Naunyn-Schmiedeberg's archives of pharmacology · 2026Article
- Patient Experience with 10 mg Intranasally Administered Zavegepant as an Acute Treatment of Migraine Attacks: Qualitative Research Findings.Neurology and therapy · 2026Article
- Pharmacologic Modulation of ARID3A with Rimegepant Reactivates Type I Interferon Signaling and Sensitizes Triple-Negative Breast Cancer to PD-1 Blockade.Advanced science (Weinheim, Baden-Wurttemberg, Germany) · 2026Article
- Atogepant reduces triptan use: a pharmacoeconomic analysis in migraine prevention.The journal of headache and pain · 2026Observational
- Consistency of response to rimegepant for the acute treatment of migraine among real-world users - findings from the prospective observational CONFIDENCE study.The journal of headache and pain · 2026Observational
- Identifying cardiac safety signals of disproportionate reporting for CGRP antagonists: evidence from the FDA Adverse Event Reporting System.Naunyn-Schmiedeberg's archives of pharmacology · 2026Article
- Review
- Migraine and the Excessive Dispensation of Triptans: A Real-World Evidence Study of Colombian Patients.Revista de neurologia · 2026Article
- Adverse events associated with gepants: a pharmacovigilance analysis based on the FDA adverse event reporting system.The journal of headache and pain · 2025Article
- Episodic Migraine Pain Curves: Real-Time Smartphone-Based Analysis and Clinical Implications.Journal of pain research · 2025Article
- Sishun Formula for acute migraine attack: study protocol for a double-blind, randomized, placebo-controlled trial.Frontiers in neurology · 2025Article
- A summary of the current circumstances of migraineurs in China: a review of the GBD2019 database.Frontiers in human neuroscience · 2025Review
- A Pharmacovigilance Study from 2004 to 2024 Utilizing the FDA Adverse Event Reporting System (FAERS) Examines Ischemic Adverse Events Linked to Triptan Use in Migraine Therapy.Journal of pain research · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Migraine, a significant cause of disability worldwide, heavily impacts daily functioning and quality of life. Despite various acute treatment options, including nonsteroidal anti-inflammatory drugs (NSAIDs) and triptans, patients experience limited relief or adverse effects. This review examines the efficacy and safety of gepants - ubrogepant, rimegepant, and zavegepant - in the acute treatment of migraine. We assessed phase II and III clinical trials, focusing on clinically relevant endpoints such as pain freedom and freedom from the most bothersome symptom at two hours post-treatment. We calculated the number needed to treat (NNT) to achieve significant endpoints for each gepant. Gepants are recommended for the acute treatment of migraine in individuals who do not respond to triptan monotherapy or combination therapy, who experience only partial effectiveness, or who cannot tolerate or have contraindications to triptans. The NNT values for achieving pain freedom at two hours were 9 for rimegepant, 11 for zavegepant, and 12 for ubrogepant, which are comparable to NSAIDs such as naproxen (NNT = 11). Paracetamol, although not an NSAID, showed similar efficacy (NNT = 12). Triptans demonstrated lower NNTs, indicating higher efficacy. Gepants offer effective, well-tolerated alternatives with no significant cardiovascular risk and minimal potential for medication-overuse headache.
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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 OpenQuestion graph.