Ubrogepant best treatment option for relieving mild migraine pain: Study

USA: A new study published in Neurology found that ubrogepant treatment against mild migraine pain resulted in greater pain relief, symptomatic outcome, and regaining of normal function two hours after administration.

For the short-term treatment of migraines, ubrogepant, an oral calcitonin gene-related peptide receptor antagonist, is being studied. In order to compare the effectiveness of ubrogepant in the treatment of migraine with mild pain with moderate or severe pain, Richard B. Lipton and colleagues carried out this study.

This 52-week extension trial was a phase-3, dose-blinded, open-label study. Adult migraine sufferers were randomized 1:1:1. (usual care, ubrogepant-50mg, or ubrogepant-100mg). Every four weeks, participants managed up to 8 migraine bouts with varying degrees of discomfort. Efficacy results (only gathered for ubrogepant) were freedom from 2-hour pain (2hPF), related symptom freedom, and disability freedom. In this post hoc analysis, the effect of baseline pain intensity on treatment outcomes was examined using a generalized linear mixed model with binomial distribution and a logit link function.

The key highlights of this study were:

1. There are details on 19,291 hits from 808 participants.

2. For attacks treated with ubrogepant-50mg when the pain was modest as opposed to moderate or severe, 2hPF rates were greater.

3. Following therapy for mild pain as opposed to moderate or severe pain, rates of relief from photophobia, phonophobia, and nausea 2 hours after treatment were similarly considerably greater.

4. For both ubrogepant dosages, the proportion of attacks with the normal function was more than twice as high at two hours. 

5. Upper respiratory tract infection was the most frequent adverse event (11% of both dosages).

6. For ubrogepant-50mg and ubrogepant-100mg, respectively, 2% and 3% of patients experienced serious adverse effects.

"Treatment with ubrogepant during mild pain resulted in significantly higher rates of freedom from pain, freedom from associated symptoms, and achieving normal function two hours after administration relative to attacks treated with moderate or severe pain," the researchers conclude. 

Reference: 

Lipton, R. B., Dodick, D., Goadsby, P. J., Burstein, R., Adams, A. M., Lai, J., Yu, S. Y., Finnegan, M., Kuang, A. W., & Trugman, J. M. (2022). Efficacy of Ubrogepant in the Acute Treatment of Migraine With Mild Pain Versus Moderate or Severe Pain. In Neurology (p. 10.1212/WNL.0000000000201031). Ovid Technologies (Wolters Kluwer Health). https://doi.org/10.1212/wnl.0000000000201031