NEW DRUG EFFECTIVE IN TREATING MIGRAINES

  

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A drug recently approved to prevent migraines may start working immediately, according to a study published on December 23, 2024, in the online issue of Neurology®, the American Academy of Neurology medical journal. The study examined the drug atogepant, a calcitonin gene-related peptide (CGRP) receptor antagonist taken by mouth.

"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."

In the study, people taking the drug-tolerant drug were less likely to have a migraine on the first day of taking it than those taking a placebo. They also had fewer migraines per week during each of the first four weeks of the study and fewer migraines overall than those taking a placebo.

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 the placebo. The PROGRESS trial, which enrolled people with chronic migraine, had 256 on the drug and 246 on the placebo.

People with episodic migraine experience up to 14 migraine days per month. People with chronic migraine experience at least 15 days of headaches per month, with at least eight days being characteristic of migraine.

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 a placebo. The numbers were 15% and 26% in the second ELEVATE trial and 51% and 61% in the third PROGRESS trial.

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 days with migraines per week, compared to an average of less than one-half day fewer per week for those taking the placebo. For the third trial, the average number of 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.

The people taking atogepants also showed improvement in assessments of how many migraines impaired their activities and overall quality of life compared to those 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."

The study's limitation is that it mainly involved female and white participants, so the results may not apply to the overall population.

The study was supported by AbbVie, the maker of atogepant.

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