Atogepant shows efficacy for prevention of migraine

Atogepant, an oral drug approved in the US for the prevention of episodic migraine treatment appears to also be effective for the prevention of chronic migraine.

The findings of the ELEVATE study were presented on April 25, 2023 at the annual meeting of the American Academy of Neurology.

“These results are exciting, as migraine can be debilitating, and this treatment led to fewer days with migraine for people who had already tried up to four other types of drugs to prevent migraine and either had no improvement or had side effects that outweighed any benefits,” said author Patricia Pozo-Rosich, MD, PhD, Director of Headache and Craniofacial Pain Clinical Unit at Vall d’Hebron University Hospital in Barcelona, Spain.

ELEVATE was a randomized, double-blind, placebo-controlled trial assessing the safety, tolerability, and efficacy of atogepant 60 mg once daily (QD) compared with placebo for the prevention of episodic migraine in adults who previously not responded to two to four classes of oral prophylactic treatments.

The primary endpoint was the change over a period of 12 weeks in mean monthly migraine days (MMDs).

The investigators enrolled 309 subjects. Of these, 56% had already failed to respond to two classes of oral migraine preventive medications, and 44% had already failed to respond to three or more classes.

The researchers reported that subjects in the atogepant 60 mg once daily arm group achieved a mean decrease of 4.20 days in MMDs across the 12-week treatment period, which was statistically significantly greater than the 1.85 day mean reduction achieved by the placebo group (p<0.0001).

Atogepant 60 mg once daily was well tolerated, and safety was consistent with prior studies of the drug.

The authors concluded, “Atogepant demonstrated statistically significant reductions in mean monthly migraine days among participants with CM [chronic migraine] and was safe and generally well-tolerated.

Pozo-Rosich added, “People who thought they may not find a way to prevent and treat their migraines may have hope of finding relief with a tolerable oral easy-to-use drug. This treatment was safe, well-tolerated and effective for people with difficult-to-treat migraine.”