0
0
A recently approved drug for migraine prevention may begin alleviating symptoms almost immediately, according to a study published in the December 23, 2024, online issue of Neurology. The study highlights the effectiveness of atogepant, a calcitonin gene-related peptide (CGRP) receptor antagonist taken orally, which could offer a breakthrough for those who struggle with long delays in the effectiveness of current treatments.
Dr. Richard B. Lipton, MD, of Albert Einstein College of Medicine in the Bronx, New York, and a Fellow of the American Academy of Neurology, explained that many existing drugs to prevent migraines require time to find the right dosage, often taking weeks or even months to work. “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,” Lipton said.
In the study, participants taking atogepant experienced fewer migraines from the very first day compared to those taking a placebo. Over the first four weeks of the study, those on the drug also reported a significant reduction in the frequency of migraines per week, and fewer migraines overall than those who received the placebo.
The research focused on three trials examining the safety and effectiveness of atogepant over 12 weeks. These trials targeted people with episodic and chronic migraines, comparing the new drug to a placebo. The ADVANCE trial enrolled 222 individuals with episodic migraine, the ELEVATE trial included 151 people who had not responded well to other preventive treatments, and the PROGRESS trial involved 256 individuals with chronic migraines.
The results were striking. In the ADVANCE trial, only 12% of participants taking atogepant experienced a migraine on the first day, compared to 25% of those on placebo. In the ELEVATE trial, the figures were 15% for the drug group and 26% for the placebo group. In the PROGRESS trial, 51% of the drug group had a migraine on the first day, compared to 61% for the placebo group.
Across all trials, participants taking atogepant were significantly less likely to have a migraine compared to those on the placebo. Specifically, in the ADVANCE trial, they were 61% less likely to have a migraine, 47% less likely in the ELEVATE trial, and 37% less likely in the PROGRESS trial. Additionally, those on the drug experienced an average reduction of one fewer migraine day per week compared to those on the placebo.
The study also found that atogepant improved patients’ quality of life and reduced the degree to which migraines impaired their daily activities. As Dr. Lipton emphasized, migraine is the second-leading cause of disability worldwide and the leading cause of disability in young women, severely impacting various aspects of their lives, including relationships, work, and finances. “Having a treatment that can act quickly and effectively addresses a key need,” Lipton said.
However, the study has some limitations, notably that the majority of participants were female and white, which means the findings may not be fully representative of the broader population.
This promising development could offer a new option for migraine sufferers seeking relief, with a medication that works quickly and efficiently from the start.
For more information, refer to the December 23, 2024, issue of Neurology.
