Analysis Finds Early Improvement With Migraine Prevention Drug
The migraine prevention drug atogepant may work immediately in patients with episodic and chronic migraine, according to a study published in Neurology.
Researchers reported the finding after analyzing outcomes for weeks 1 through 4 from a trio of phase 3 randomized trials.
“The analyses reported here demonstrate the early efficacy and functional improvements of atogepant and address a key unmet need of providing preventive treatment options with early benefits across the spectrum of migraine disease state severity,” wrote corresponding author Jonathan H. Smith, MD, of AbbVie, North Chicago, Illinois, and study coauthors.
The study investigated how quickly improvements occurred in the double-blind, 12-week ADVANCE, ELEVATE, and PROGRESS trials. ADVANCE included 222 patients with episodic migraine randomized to atogepant and 214 to placebo. ELEVATE included patients with episodic migraine who had not responded well to other oral treatments: 151 received atogepant and 154 placebo. PROGRESS focused on patients with chronic migraine and assigned 256 to atogepant and 246 to placebo.
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On day 1 of the studies, migraine was experienced by 25% of patients with placebo compared with 12% with atogepant in ADVANCE. In ELEVATE, 26% experienced a day-1 migraine with placebo compared with 15% with atogepant. In PROGRESS, 61% experienced migraine with placebo compared with 51% with atogepant on day 1.
After adjustment for confounding factors, analysis indicated patients on atogepant were 61% less likely than those on placebo to have a day-1 migraine in ADVANCE, 47% less likely in ELEVATE, and 37% less likely in PROGRESS.
The study also found patients in ADVANCE and ELEVATE averaged 1 less day of migraine per week with atogepant compared with under a half day less per week with placebo. In PROGRESS, migraine days per week declined approximately 1.5 days on average with atogepant compared with approximately 1 day on average with placebo.
In functional outcomes, Activity Impairment in Migraine-Diary and European Quality-of-Life 5-Dimension 5-Level scores at weeks 1 through 4 also improved with atogepant compared with placebo.
Because study participants were mostly female and White, results may not be generalizable to the overall population, researchers noted. The maker of atogepant, AbbVie, supported the study.
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