The efficacy of NURTEC ODT for the acute treatment of migraine with and without aura in adults was demonstrated in a randomized, double-blind, placebo-controlled trial: Study 1 (NCT03461757). The study randomized patients to 75 mg of NURTEC ODT (N=732) or placebo (N=734). Patients were instructed to treat a migraine of moderate to severe headache pain intensity. Rescue medication (i.e., NSAIDs, acetaminophen, and/or an antiemetic) was allowed 2 hours after the initial treatment. Other forms of rescue medication such as triptans were not allowed within 48 hours of initial treatment. Approximately 14% of patients were taking preventive medications for migraine at baseline. None of the patients in Study 1 were on concomitant preventive medication that act on the CGRP pathway.
The primary efficacy analyses were conducted in patients who treated a migraine with moderate to severe pain. NURTEC ODT 75 mg demonstrated an effect on pain freedom and most bothersome symptom (MBS) freedom at two hours after dosing, compared to placebo. Pain freedom was defined as a reduction of moderate or severe headache pain to no headache pain, and MBS freedom was defined as the absence of the self-identified MBS (i.e., photophobia, phonophobia, or nausea). Among patients who selected an MBS, the most commonly selected symptom was photophobia (54%), followed by nausea (28%), and phonophobia (15%).
In Study 1, the percentage of patients achieving headache pain freedom and MBS freedom two hours after a single dose was statistically significantly greater in patients who received NURTEC ODT compared to those who received placebo (Table 1).
Table 1: Migraine Efficacy Endpoints for Study 1
| Study 1 | |
| NURTEC ODT
75 mg
| Placebo |
| Pain Free at 2 hours | | |
| n/N* | 142/669 | 74/682 |
| % Responders | 21.2 | 10.9 |
| Difference from placebo (%) | 10.3 | |
| p-value | | <0.001 |
| MBS Free at 2 hours | | |
| n/N* | 235/669 | 183/682 |
| % Responders | 35.1 | 26.8 |
| Difference from placebo (%) | 8.3 | |
| p-value | | 0.001 |
*n=number of responders/N=number of patients in that treatment group
Figure 1 presents the percentage of patients achieving migraine pain freedom within 2 hours following treatment in Study 1.
Figure 1: Percentage of Patients Achieving Pain Freedom within 2 Hours in Study 1
Figure 2 presents the percentage of patients achieving MBS freedom within 2 hours in Study 1.
Figure 2: Percentage of Patients Achieving MBS Freedom within 2 Hours in Study 1
Table 2. Additional Migraine Efficacy Endpoints in Study 1
| Study 1 |
| NURTEC ODT
75 mg
| Placebo |
| Pain Relief at 2 hours | | |
| n/N* | 397/669 | 295/682 |
| % Responders | 59.3 | 43.3 |
| Difference from placebo | 16.1 | |
| p-value | | <0.001 |
Sustained Pain Freedom 2-48 hours | | |
| n/N* | 90/669 | 37/682 |
| % Responders | 13.5 | 5.4 |
| Difference from placebo | 8.0 | |
| p-value | | <0.001 |
Use of Rescue Medication within 24 hours** | | |
| n/N* | 95/669 | 199/682 |
| % Responders | 14.2 | 29.2 |
| Difference from placebo | -15.0 | |
| p-value | | <0.001 |
| Percentage of Patients Reporting Normal Function at 2 hours | | |
| n/N* | 255/669 | 176/682 |
| % Responders | 38.1 | 25.8 |
| Difference from placebo | 12.3 | |
| p-value | | <0.001 |
*n=number of responders/N=number of patients in that treatment group
**This analysis includes only the use of NSAIDs, acetaminophen, or antiemetics, within 24 hours post-dose; the use of triptans, or other acute migraine medication, was not allowed.
The incidence of photophobia and phonophobia was reduced following administration of NURTEC ODT 75 mg as compared to placebo.