Jessica Ailani M.D. FAHS FAAN FANA Director Medstar Georgetown Headache Center Vice Co-Chair of Strategic Planning for MedStar Neurology Professor of Clinical Neurology MedStar Georgetown University Hospital

Episodic Migraine: Atogepant Effective At Reducing Migraine Days

MedicalResearch.com Interview with:

Jessica Ailani M.D. FAHS FAAN FANA Director Medstar Georgetown Headache Center Vice Co-Chair of Strategic Planning for MedStar Neurology Professor of Clinical Neurology MedStar Georgetown University Hospital

Dr. Ailani

Jessica Ailani M.D. FAHS FAAN FANA
Director Medstar Georgetown Headache Center
Vice Co-Chair of Strategic Planning for MedStar Neurology
Professor of Clinical Neurology
MedStar Georgetown University Hospital

MedicalResearch.com: What is the background for this study?

Response: Migraine is a common neurological disease that causes disabling attacks that can be frequent. Preventive treatments can help reduce the frequency of attacks and improve patient function, reducing disease burden.

MedicalResearch.com: What are the main findings?

Response: Atogepant is an oral, small-molecule, calcitonin gene-related peptide receptor antagonist that was studied for the prevention of migraine. Three doses of atogepant, 10mg, 30mg, and 60mg daily were evaluated vs. placebo over 12 weeks. Each dose of atogepant was found to significantly reduce migraine days over 3 months. Atogepant 30mg and 60mg each met all secondary endpoints including improvement in patient performance of daily activities score and improvement in patient physical impairment score.

MedicalResearch.com: What should readers take away from your report?

Response: Atogepant is effective in reducing migraine days in patients who have episodic migraine attacks. Atogepant was well tolerated in clinical trials with the most common side effects being constipation (rates up to 7.7% of atogepant treated groups) and nausea (rates up to 6.1% in atogepant treated groups). 

MedicalResearch.com: What recommendations do you have for future research as a result of this work? 

Response: Future studies will focus on if atogepant can be effective in reducing migraine days in patients who have chronic migraine. This would be a big advance in our field to allow an oral preventive medication that was created for migraine to prevent both episodic and chronic migraine.

MedicalResearch.com: Is there anything else you would like to add?

Response: Atogepant represents an exciting time in the field of caring for those with migraine. Having disease specific treatment options for patients with limited side effects that allow for oral dosing allows for flexibility for our patients.

Disclosures for the past 24 months

Consulting: (Honoraria for independent consulting) Amgen, Abbvie, Biohaven, Eli Lilly and Company, GlaxoSmithKline, Lundbeck, Teva, Impel, Satsuma, Axsome, Vorso, Aeon, Theranica, Medscape

Ownership of Stocks: CtrM

Speakers Bureau [ended 2020]: (Honoraria for promotional speaking) Allergan/Abbvie, Amgen, Biohaven, Eli Lilly and Company, Lundbeck, Teva

Editorial services: (Honoraria) Current Pain and Headache Reports, Section editor, Unusual Headache Syndromes, NeurologyLive, Infomedica (AHS Virtual Highlights 2020), SELF (medical reviewer)

Clinical Trial Grants: (Fees to Institution) American Migraine Foundation, Allergan/Abbvie, Biohaven, Eli Lilly and Company, Satsuma, Zosano

Citation:

Atogepant for the Preventive Treatment of Migraine

Jessica Ailani, M.D., Richard B. Lipton, M.D., Peter J. Goadsby, M.D., Hua Guo, Ph.D., Rosa Miceli, B.S.N., Lawrence Severt, M.D., Michelle Finnegan, M.P.H., and Joel M. Trugman, M.D.  for the ADVANCE Study Group
August 19, 2021
N Engl J Med 2021; 385:695-706
DOI: 10.1056/NEJMoa2035908

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Last Updated on August 18, 2021 by Marie Benz MD FAAD