Positioning rimegepant in migraine prophylaxis: updated evidence and emerging perspectives.

INTRODUCTION

Migraine is among the most disabling neurological disorders worldwide and preventive treatment remains a cornerstone for reducing disease burden. Recent advances in mechanism-based therapies have positioned calcitonin gene-related peptide (CGRP) and its main receptor as central targets for migraine prophylaxis.

AREAS COVERED: This updated narrative overview summarizes the pharmacological profile, clinical efficacy, safety and regulatory status of rimegepant, integrating evidence published through 2025 and highlighting emerging real-world and clinical trends. Relevant literature was identified through searches in PubMed/MEDLINE and Scopus (last search: 19 November 2025) using predefined combinations of terms related to rimegepant and migraine. The review also examines emerging concepts such as situational prevention, potential combination approaches with traditional or novel preventives and exploratory use in other CGRP-mediated headache disorders.

EXPERT OPINION: Rimegepant represents a significant addition to migraine prophylaxis by offering a flexible and well-tolerated option that bridges acute and preventive care. Its role may expand through rational combinations and investigation in other headache disorders. Persistence and long-term safety require careful monitoring, and reimbursement frameworks will determine its future clinical adoption.