JANUARY 10, 2025
New research suggests that atogepant, a calcitonin gene−related peptide receptor antagonist, may work immediately to prevent migraines.
The study, published online in Neurology, (2025 Jan 28;104(2):e210212) shows that patients treated with atogepant were less likely to experience a migraine on the first day of medication than those treated with a placebo. This group also had fewer migraines during each of the first four weeks of the study and fewer migraines during the entire 12-week
New research suggests that atogepant, a calcitonin gene−related peptide receptor antagonist, may work immediately to prevent migraines.
The study, published online in Neurology, (2025 Jan 28;104(2):e210212) shows that patients treated with atogepant were less likely to experience a migraine on the first day of medication than those treated with a placebo. This group also had fewer migraines during each of the first four weeks of the study and fewer migraines during the entire 12-week study.
“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, a neurologist with Albert Einstein College of Medicine in New York City. “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 is the Edwin S. Lowe Professor and vice chair of neurology, professor of epidemiology and population health and professor of psychiatry and behavioral sciences.
In the study, investigators analyzed data from three trials testing the safety and efficacy of atogepant over 12 weeks, focusing on how quickly improvements occurred compared with placebo.
The positive results are based on three trials: the ADVANCE trial, which included 222 patients treated with atogepant and 214 participants given a placebo; the ELEVATE trial, which examined patients with episodic migraines who had previously not responded well to other oral preventive treatments; and the PROGRESS trial, which compared 256 patients with chronic migraines treated with atogepant and 246 given a placebo.
The ADVANCE trial showed that 12% of the atogepant group experienced a migraine on the first day of the study, compared with 25% in the placebo group. In the ELEVATE trial, 15% of those treated with atogepant experienced a migraine on day 1, compared with 26% in the placebo group. Finally, 51% of the atogepant group experienced a migraine on day 1 in the PROGRESS trial, compared with 61% in the placebo group.
After adjusting for other factors, patients treated with atogepant were 61% less likely to have a migraine in the ADVANCE trial, 47% less likely in the ELEVATE trial, and 37% less likely in the PROGRESS trial.
Overall, individuals treated with atogepant had an average of one fewer migraine day per week in the first two trials, compared with less than one-half day fewer per week in the placebo group. In the PROGRESS trial, the atogepant group had an average reduction of about 1.5 migraine days per week, compared with one day in the placebo group.
—Kenneth Walter
