A newly authorized medication for migraine prevention may provide prompt relief, based on findings from a recent study. The research focused on atogepant, a medication that acts as a calcitonin gene-related peptide (CGRP) receptor antagonist and is administered orally.
A newly authorized medication for migraine prevention may provide prompt relief, based on findings from a study published in the December 23, 2024 online issue of Neurology®, the journal of the American Academy of Neurology. The research centered on atogepant, an oral calcitonin gene-related peptide (CGRP) receptor antagonist.
“Many existing migraine prevention medications require time to determine the appropriate dosage and can take weeks or even months to become fully effective,” explained study author Richard B. Lipton, MD, from Albert Einstein College of Medicine in the Bronx, New York, who is also a Fellow of the American Academy of Neurology. “Some individuals discontinue the medication before it has a chance to work. Additionally, many current treatments come with side effects. Thus, creating a drug that is both effective and fast-acting is crucial.”
The study revealed that participants using atogepant experienced fewer migraines on the first day of treatment compared to those receiving a placebo. Over the initial four weeks, they reported fewer migraine days each week and a lower total number of migraines compared to the placebo group.
For this research, scientists analyzed data from three different trials assessing the safety and efficiency of atogepant over a 12-week duration to evaluate the rapidity of improvement. The ADVANCE trial involved 222 participants receiving atogepant and 214 on placebo, all with episodic migraine. The ELEVATE trial included 151 participants on the drug and 154 on placebo, focusing on individuals with episodic migraine who had not responded well to other oral preventive measures. The PROGRESS trial had 256 participants taking the drug and 246 on placebo, involving those with chronic migraine.
People experiencing episodic migraine may suffer up to 14 migraine days per month, while those with chronic migraine endure at least 15 headache days monthly, with a minimum of eight classified as migraine.
On the initial day of the ADVANCE trial, 12% of those on atogepant reported a migraine, in contrast to 25% of the placebo group. In the ELEVATE trial, these figures were 15% for the drug group versus 26% for placebo. The PROGRESS trial showed 51% of the atogepant group had a migraine compared to 61% in the placebo group.
After adjusting for various factors affecting migraine occurrence, researchers found those taking atogepant were 61% less likely to have a migraine in the ADVANCE trial, 47% less likely in ELEVATE, and 37% less likely in PROGRESS.
In the first two trials, participants on atogepant experienced an average of one fewer migraine day per week, in contrast to just under half a day less for the placebo group. In the PROGRESS trial, weekly migraine days decreased by approximately 1.5 days for those on atogepant, compared to around one day for the placebo group.
Additionally, individuals taking atogepant reported improvements in how much their migraines disrupted their daily activities and their overall quality of life compared to the placebo group.
“Migraine is the second most common cause of disability in the population and the primary cause among young women, affecting their relationships, parenting, careers, and finances,” Lipton stated. “Having a treatment that acts quickly and effectively addresses an important need.”
One limitation of the study is its predominance of female and white participants, which may limit the applicability of the results to the wider population.
This research was funded by AbbVie, the company behind atogepant.
