A recently analyzed drug, atogepant, already approved for migraine prevention, may provide relief from the first dose, according to a study published in Neurology. The analysis of data from three clinical trials indicates that atogepant, a calcitonin gene-related peptide (CGRP) receptor antagonist, offers a quick-acting treatment option for individuals struggling with migraines, a condition affecting millions worldwide.
Quick Relief
Unlike existing migraine treatments that can take weeks or months to show significant effects, atogepant appears to deliver benefits much sooner. The researchers analyzed data from three Phase 3 clinical trials—ADVANCE, ELEVATE, and PROGRESS—to assess the drug's efficacy over the first four weeks of treatment. These trials included participants with both episodic and chronic migraines. Episodic migraines are characterized by up to 14 migraine days per month, while chronic migraines involve at least 15 headache days per month, with at least eight days exhibiting migraine symptoms.
Trial Results
In the ADVANCE trial, 12% of participants taking atogepant experienced a migraine on the first day, compared to 25% in the placebo group. The ELEVATE trial showed similar results, with 15% of participants on atogepant experiencing a migraine on the first day versus 26% in the placebo group. The PROGRESS trial, which focused on individuals with chronic migraines, found that 51% of those on atogepant had migraines on the first day, compared to 61% in the placebo group. Across all three studies, atogepant treatment led to greater reductions in the proportion of participants with a migraine by day 1 (OR = 0.39; 95% CI, 0.23–0.67) in ADVANCE, (OR = 0.53; 95% CI 0.29–0.94) in ELEVATE and (OR = 0.63; 95% CI, 0.43–0.93) in PROGRESS.
Lasting Benefits
Over the course of the trials, atogepant also demonstrated lasting benefits. Participants experienced fewer migraines overall compared to those on a placebo. On average, participants saw their migraine days reduced by about one to 1.5 days per week depending on the trial, compared to less than one day for those not on the drug. Beyond just the numbers, those on atogepant reported improvements in how migraines impacted their lives. Everyday activities became easier, and their overall quality of life improved.
Expert Commentary
"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 Richard B. Lipton, MD, a professor of neurology at Albert Einstein College of Medicine. "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."
Impact on Patients
Migraine is a leading cause of disability worldwide, affecting people’s ability to maintain relationships, parent, work, and manage their finances. For young women, it’s particularly significant, as they are among the most affected groups. Having a treatment that works quickly and consistently could help ease the burden for millions. The fast onset of atogepant’s effects might encourage more people to stick with the treatment, as they can see tangible benefits early on. This could make a huge difference, especially for those who have previously given up on other medications due to slow results or unpleasant side effects.
Study Limitations
Most participants in these trials were women and white, so it’s not yet clear how the results apply to a broader population. Still, the findings are encouraging and point to atogepant as a promising option for managing migraines. The study was supported by AbbVie, the maker of atogepant.
