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Objective This randomized open-label study evaluated rimegepant 75 mg ODT for prevention of fasting-related headache during Ramadan.Methods Participants received rimegepant 75 mg once daily (QD) for Days 1–28 of the fast (Arm 1) or for Days 8–28 of the fast (Arm 2). Primary endpoint was number of headache days (HDs) during Week 1. Secondary endpoints included number of HDs during Weeks 2–4, proportion of participants with moderate-to-severe headache, and treatment satisfaction. Safety endpoints included proportion of participants discontinuing treatment due to adverse events (AEs) and frequency of serious AEs (SAEs).Results 105 participants were treated (Arm 1 n=52, Arm 2 n=53). HDs during Week 1 were fewer in Arm 1 than Arm 2 (mean: 1.75 vs 2.85). Fewer participants had moderate-to-severe headaches during Week 1 in Arm 1 than in Arm 2 (28 vs 60%). HDs during the 4-week study were fewer in Arm 1 than Arm 2 (mean: 4.23 vs 6.08). Most participants (81%) reported being satisfied, very satisfied, or extremely satisfied with treatment. Treatment discontinuations due to AEs were low and no treatment-related SAEs occurred.Conclusions Rimegepant 75 mg ODT QD may be effective and well tolerated for prevention of fasting-related headache/migraine during Ramadan.grant.oneil@pfizer.com