Atogepant effectively prevents episodic migraine: ELEVATE Study

Written By : Jacinthlyn Sylvia |Medically Reviewed By : Dr. Kamal Kant Kohli Published On 2023-04-24T09:45:27+05:30 | Updated On 24 April 2023 1:48 PM IST

The ELEVATE study found that atogepant (Qulipta) outperformed placebo for preventing migraines in patients with episodic migraine who were resistant to therapy.

Atogepant is an oral calcitonin gene-related peptide (CGRP) receptor antagonist (gepant) that was authorized in 2021 to prevent episodic migraine, an indication that was expanded this week to include chronic migraine prevention. CGRP, a powerful vasodilator peptide, is suspected to play a role in migraine.

In contrast to the injectable anti-CGRP monoclonal antibodies licensed for migraine prophylaxis in recent years (erenumab (Aimovig), galcanezumab (Emgality), fremanezumab (Ajovy), and eptinezumab (Vyepti), atogepant and other gepants are small-molecule medicines that can be taken orally.

This double-blind ELEVATE study, conducted by Pozo-Rosich P and colleagues, had 309 subjects from North America and Europe in its effectiveness analysis population; 154 were randomized to once-daily atogepant 60 mg and 155 to placebo. Participants had a minimum of one year of migraine history, with or without aura. During the study's 28-day screening phase, everyone had previously failed two to four oral migraine medicines and reported 4 to 14 monthly migraine days. Overall, 56% of individuals failed two classes of oral prophylactic medicines, with 44% failing three or more. The primary objective was the change in monthly migraine days from baseline to 12 weeks.

The key findings of this study were:

1. Constipation (10.3% for atogepant vs. 2.5% for placebo), nausea (7.1% vs 3.2%), COVID-19 (8.3% vs. 9.6%), and nasopharyngitis (5.1% vs 7.6%) were the most often reported treatment-emergent side effects.

2. Compared to placebo, episodic migraine patients who had previously failed oral preventive therapy experienced a substantially larger decrease in monthly migraine days with once-daily atogepant 60 mg (-4.20 days) after 12 weeks.

People who thought there was no way to prevent and manage migraines may find relief with a pleasant, oral, easy-to-use medication. For those suffering from difficult-to-treat migraines, this medication was safe, well-tolerated, and effective.

Reference:

Pozo-Rosich P, et al "Atogepant for the preventive treatment of migraine among participants with episodic migraine with prior treatment failure: Results from the ELEVATE trial" AAN 2023

atogepantmigraineepisodic migraineAmerican Academy of Neurology

Source : American Academy of Neurology

Jacinthlyn Sylvia

Neuroscience Masters graduate

Jacinthlyn Sylvia, a Neuroscience Master's graduate from Chennai has worked extensively in deciphering the neurobiology of cognition and motor control in aging. She also has spread-out exposure to Neurosurgery from her Bachelor’s. She is currently involved in active Neuro-Oncology research. She is an upcoming neuroscientist with a fiery passion for writing. Her news cover at Medical Dialogues feature recent discoveries and updates from the healthcare and biomedical research fields. She can be reached at editorial@medicaldialogues.in

Dr. Kamal Kant Kohli

Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751