Biohaven Pharmaceutical announced that it is completing enrollment in the first of its two registrational Phase 3 clinical trials, Study BHV3000-301, to establish the safety and efficacy of orally-dosed rimegepant. Study BHV3000-301 has enrolled over 1,400 subjects since July 2017. Rimegepant is a second generation, oral, calcitonin gene related peptide (CGRP) receptor antagonist being developed for the acute treatment of migraine. Rimegepant has composition of matter protection until 2030, not including patent term adjustment or any potential patent term extension. Rimegepant is one of only two small molecule CGRP-receptor antagonists in late stage clinical development.
CGRP-receptor antagonists represent a novel class of drug candidates designed to block the molecules in the body responsible for pain and associated symptoms that occur during a migraine attack. Additionally, large numbers of migraine patients, especially those with cardiovascular disease or hypertension for whom existing treatment options such as triptans are contraindicated, may benefit from safe and effective oral CGRP-receptor antagonists since this class of drugs is not associated with vasoconstriction.
"Completing enrollment in this large Phase 3 pivotal trial in four months reflects the high unmet need of people with migraine and dissatisfaction with current treatment approaches. Our team has focused on advancing small molecule CGRP-receptor antagonists in convenient and easy to use oral or intranasal formulations for patients to control migraines when and where a debilitating attack hits,” Vlad Coric, M.D., Chief Executive Officer at Biohaven said. “We want to give patients the means to control their migraines in their own hands—tablets comprise the vast majority of migraine therapy prescriptions reflecting patient preference while nasal formulations provide rapid, non-invasive treatment. Based upon our Phase 2 data, we believe our lead candidate, rimegepant, has the potential to be a best-in-class and first-in-class treatment option for the acute treatment of migraine."
In a previously completed Phase 2b clinical trial, the 75 mg dose of rimegepant was observed to have achieved a statistically significant improvement compared to placebo at two hours post-dosing on all four key migraine symptoms: pain, nausea, photophobia and phonophobia. To the Company's knowledge, rimegepant is the only oral, small molecule CGRP-receptor antagonist currently in development that has achieved statistically significant improvements on all four of these key migraine symptoms within a single study. Rimegepant treated patients also experienced durable efficacy, achieving statistically higher rates of pain freedom at 24 and 48 hours post-dosing compared to placebo. Durability of treatment response is an important unmet need not fulfilled by current treatment options.
Biohaven is conducting two double-blind, placebo-controlled Phase 3 clinical trials to evaluate the efficacy and safety of 75 mg of rimegepant, Biohaven's innovative, orally-dosed small molecule CGRP-receptor antagonist, for the acute treatment of migraine. The co-primary endpoints of the studies are freedom from pain at two hours post-dosing and freedom from the patient's most bothersome symptom (nausea, photophobia or phonophobia) at two hours post-dosing. Patients who have participated in the Phase 3 clinical trials may be eligible to participate in a long-term safety study. In addition to rimegepant, Biohaven is also pursuing the development of its third generation CGRP-receptor antagonist, BHV-3500, for the acute and preventive treatment of migraine.
Migraine is both a widespread and disabling neurological disease. The Migraine Research Foundation ranks migraine as the world's third most prevalent illness, affecting approximately 36 million people in the United States. Current treatment approaches, such as triptans, can be limited by headache recurrence within 24 hours after taking migraine medication, as well as cardiovascular contraindications and warnings.