A newly approved drug to prevent migraine may start working right away, according to a study published in the Dec. 23, 2024, online edition of Neurology®the medical journal of the American Academy of Neurology. The study looked at the drug atogepant, which is a calcitonin gene-related peptide (CGRP) receptor antagonist taken orally.
“With many current migraine prevention medications, it takes time to find the right dose for the individual and it may take weeks or even months for it to be most effective,” said study author Richard B. Lipton, MD, of the Albert Einstein College of Medicine. College. of Medicine in the Bronx, New York, and a member of the American Academy of Neurology. “Some people give up and stop taking medications before reaching this point. Additionally, many people experience side effects with current treatments. Developing a medication that works effectively and quickly is critical.”
In the study, people who took the drug atogepant were less likely to have a migraine on the first day of taking the drug compared to those who took a placebo. They also had fewer migraines per week during each of the first four weeks of the study and fewer migraines during the study overall than those who took a placebo.
For this study, researchers analyzed data from three trials on the safety and effectiveness of atogepant over 12 weeks to focus on how quickly improvements appeared. In the ADVANCE trial, which enrolled people with episodic migraine, 222 people took the drug and 214 took a 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 headache days 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 placebo. In the second trial, the ELEVATE trial, the figures were 15% and 26%. For the third trial, the PROGRESS trial, the figures were 51% and 61%.
When the researchers adjusted for other factors that could affect migraine rates, 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 to have a migraine in the second trial. % less likely in the third trial.
For the first two trials, people taking atogepant had an average of one fewer migraine day per week, compared with an average of less than half a day less per week for those taking the placebo. For the third trial, the average number of migraine days per week decreased by about 1.5 days for those taking the drug compared to about one day for those taking the placebo.
People taking atogepant also showed improvements in assessments of how much their migraine affected their activities and overall quality of life compared to people taking the placebo.
“Migraine is the second leading cause of disability in the general population and the leading cause of disability in young women, and people report negative effects on their relationships, parenting, career and finances,” Lipton said. “Having a treatment that can act quickly and effectively addresses a key need.”
One limitation of the study is that it primarily involved female and white participants, so the results may not apply to the general population.
The study was supported by AbbVie, the maker of atogepant.