Atogepant Effective for Chronic Migraine

A recent study, featured in the online edition of Neurology on June 27, 2024, reveals that atogepant is effective in treating chronic migraine (CM) in patients, regardless of their medication overuse. Dr. Peter J. Goadsby from King's College London led a team of researchers to investigate the preventive benefits of atogepant for CM, focusing on patients both with and without a history of acute medication overuse.

The study included participants who had suffered from CM for over a year, experiencing at least 15 monthly headache days (MHDs) and a minimum of eight monthly migraine days (MMDs) during the four-week baseline period. Participants were divided randomly into three groups to receive either a placebo, atogepant 30 mg twice daily (BID), or atogepant 60 mg once daily (QD) over a period of 12 weeks.

Results indicated that 66.2 percent of the 755 participants in the modified intent-to-treat population had baseline acute medication overuse. The least squares mean difference (LSMD) in MMDs between the atogepant groups and the placebo was -2.7 for the 30 mg BID group and -1.9 for the 60 mg QD group. Reductions were also observed in mean MHDs, with LSMDs of -2.8 for the 30 mg BID group and -2.1 for the 60 mg QD group. Furthermore, there was a decrease in mean acute medication use days, with LSMDs of -2.8 and -2.6 for the 30 mg BID and 60 mg QD groups, respectively.

An increase was observed in the proportion of participants achieving at least a 50 percent reduction in MMDs. The odds ratios for this improvement were 2.5 for the 30 mg BID group and 2.3 for the 60 mg QD group. Additionally, the proportion of atogepant-treated participants who met the criteria for acute medication overuse decreased significantly, ranging from 52.1 percent to 61.9 percent over the 12-week period.

Patient-reported outcomes also showed improvement with atogepant treatment. The study suggests that atogepant may help reduce the risk of rebound headaches by lowering the dependency on pain medications. Dr. Goadsby highlighted this potential benefit in his statement.

Several authors of the study disclosed that they have affiliations with biopharmaceutical companies, including AbbVie, which is the manufacturer of atogepant and the funder of the study.

The study’s findings point to the potential of atogepant as a beneficial treatment for chronic migraine, offering hope for improved management of this debilitating condition.