AbbVie's Ubrelvy Prevents Migraines When Used at Early Signs

AbbVie's Ubrelvy has gained a significant position in the migraine treatment market, despite its approval being limited to treating migraines rather than preventing them. Recent studies, however, suggest that Ubrelvy, a CGRP inhibitor, might effectively prevent migraines when taken at the earliest signs of an impending headache. This potential new use was highlighted in a study published in Neurology, which found that Ubrelvy was 73% more effective than a placebo in preventing migraine attacks.

The phase 3 PRODROME trial included 518 participants who had experienced 2 to 8 migraines per month for at least a year. These patients were instructed to take their medication upon noticing early warning signs of a migraine, such as fatigue, dizziness, visual aura, neck pain, and sensitivity to light and sound. During the initial phase of the study, each participant experienced two migraine episodes over two months, during which they received either a 100 mg dose of Ubrelvy or a placebo. In the subsequent phase, participants switched treatments, receiving the alternative to what they had been given initially.

The study's results were promising. After 24 hours, 65% of those who took Ubrelvy reported minimal to no limitations in their activities, compared to 48% of those who received a placebo. Moreover, within two hours of taking Ubrelvy, patients were 73% more likely to report being free of disability and able to function normally compared to those on the placebo. Dr. Richard Lipton, vice chair of neurology at the Albert Einstein College of Medicine, emphasized that these findings suggest that Ubrelvy could allow people to manage their migraines more effectively by treating them at the earliest stages, thus minimizing discomfort and disruption to daily life.

These new findings corroborate earlier results from the PRODROME trial published in The Lancet in November of the previous year. That study indicated that 46% of patients who took Ubrelvy reported an absence of moderate or severe headaches within 24 hours, compared to 29% of those taking a placebo.

Approved in 2019, Ubrelvy achieved sales of $815 million in 2023. It is part of a class of medications known as calcitonin gene-related peptide (CGRP) antagonists, which are used to treat migraine headaches. AbbVie also markets Qulipta, another CGRP antagonist approved in 2021 for migraine prevention, which brought in $408 million in sales last year.

Despite its success, Ubrelvy faces competition from several other CGRP inhibitors. Pfizer's Nurtec, approved in 2020 and endorsed for preventative use in 2021, led the market with $928 million in sales last year. Additionally, three other CGRP inhibitors, all approved in 2018 for migraine prevention, continue to be strong competitors. Eli Lilly's Emgality generated $678 million in sales, Teva's Ajovy brought in $435 million, and Amgen's Aimovig collected $303 million in revenue last year.

These findings and the potential new use of Ubrelvy for early migraine intervention could significantly impact its market presence and provide patients with a more effective option for managing their condition.

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