A groundbreaking study finds that Atogepant, the new migraine prevention drug, offers immediate relief, reducing migraine occurrences right from the first day of use, significantly enhancing life quality for patients.
A recently approved migraine prevention drug, atogepant, may start working immediately, according to a study published today (December 23, 2024) in the online edition of Neurology, the journal of the American Academy of Neurology. Atogepant is an oral calcitonin gene-related peptide (CGRP) receptor antagonist designed to reduce migraine frequency.
The Challenge of Current Migraine Treatments
“With many current drugs to prevent migraine, it takes time to find the right dosage for the individual and it can take weeks or even months for it to be most effective,” said study author Richard B. Lipton, MD, of Albert Einstein College of Medicine in the Bronx, New York, and a Fellow of the American Academy of Neurology. “Some people give up and stop taking the drugs before they reach this point. Plus, many people experience side effects with current treatments. Developing a drug that works both effectively and quickly is critical.”
Early Effects of Atogepant on Migraine Frequency
The study found that participants taking atogepant were less likely to experience migraines on the first day compared to those taking a placebo. Additionally, they had fewer migraines each week during the first four weeks and overall throughout the study than participants in the placebo group.
For this study, researchers looked at the data from three trials on the safety and effectiveness of atogepant over 12 weeks to focus on how rapidly improvements appeared. The ADVANCE trial, which enrolled people with episodic migraine, had 222 people taking the drug and 214 taking placebo. The ELEVATE trial, which enrolled people with episodic migraine who had previously not responded well to other oral preventive treatments, had 151 on the drug and 154 on placebo. The PROGRESS trial, which enrolled people with chronic migraine, had 256 on the drug and 246 on placebo.
People with episodic migraine experience up to 14 migraine days per month. People with chronic migraine experience at least 15 days with headache per month, with at least eight days being characteristic of migraine.
Significant Results Across Different Trials
On the first day of the study, 12% of those taking the drug in the first trial, the ADVANCE trial had a migraine, compared to 25% of those taking placebo. In the second trial, the ELEVATE trial, the numbers were 15% and 26%. For the third trial, the PROGRESS trial, the numbers were 51% and 61%.
When researchers adjusted for other factors that could affect the rate of migraine, they found that people taking the drug were 61% less likely to have a migraine in the first trial, 47% less likely in the second trial, and 37% less likely in the third trial.
For the first two trials, the people taking atogepant had an average of one fewer day with migraine per week, compared to an average of less than one-half day fewer per week for those taking the placebo. For the third trial, average migraine days per week declined by about 1.5 days for those taking the drug compared to about one day for those taking the placebo.
Impact on Quality of Life
The people taking atogepant also showed improvement on assessments of how much migraine impaired their activities and their overall quality of life compared to people taking the placebo.
“Migraine is the second-leading cause of disability in the overall population and the leading cause of disability in young women, with people reporting negative effects on their relationships, parenting, career and finances,” Lipton said. “Having a treatment that can act quickly and effectively addresses a key need.”
A limitation of the study is that it involved mostly female and white participants, so the results may not apply to the overall population.
Reference: “Early Improvements With Atogepant for the Preventive Treatment of MigraineResults From 3 Randomized Phase 3 Trials” by Richard B. Lipton, Pranav Gandhi, Cristina Tassorelli, Uwe Reuter, Andrea M. Harriott, Dagny Holle-Lee, Christopher H. Gottschalk, Brian Neel, Yingyi Liu, Hua Guo, Jonathan Stokes, Krisztian Nagy, Brett Dabruzzo and Jonathan H. Smith, 23 December 2024, Neurology.
DOI: 10.1212/WNL.0000000000210212
The study was supported by AbbVie, the maker of atogepant.
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