Impressive Response Rates for Patients in Migraine Prevention Study: Peter J. Goadsby, MD, PhD, DSc

WATCH TIME: 5 minutes

"Half the patients are losing half of their disabling migraine attacks, despite the fact that there's a group of patients who came into this study had failed preventives, up to four preventives, in the past. It's really important from a clinical practice point of view because these are the sort of patients who we see in our practice every day."

Atogepant (Quilipta; AbbVie), an oral calcitonin gene-related peptide receptor antagonist, was originally approved in September 2021, based on the results of its full clinical development program, namely, the ADVANCE study (NCT02848326).¹ Years later, in April 2023, the FDA expanded the indication for the treatment to include the prevention of chronic migraine in adults, adding to its existing indication for episodic migraine.²

At the 2023 American Academy of Neurology (AAN) Annual Meeting, April 22-27, in Boston, Massachusetts, positive data from the phase 3 global, randomized, double-blind, placebo-controlled trial ELEVATE (NCT04740827) was presented, assesing atogepant for the prevention of episodic migraine in adult patients who had previously failed 2 to 4 classes of oral preventive medications.³ In the trial, the primary end point was the change from baseline in mean monthly migraine days (MMDs) across the span of 12 weeks, while secondary end points looked at the achievement of more than 50% reduction in MMDs, change from baseline in MMDs, and change from baseline in acute medication use days.

Peter J. Goadsby, MD, PhD, DSc, a professor of neurology at both the University of California San Francisco and King’s College, London, sat down with NeurologyLive^® in an interview at the AAN 2023 to discuss the findings from the study from a clinical perspective. He also talked about the limitations of the study design as well as the adverse events of the treatment observed in patients. Goadsby, the director of the NIHR-Wellcome Trust Clinical Research Facility at King’s College Hospital and the Chair of the British Association for the Study of Headache, also spoke about the what should be further investigated with this treatment in the field, and the next steps to clinical care for migraine.

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REFERENCES
1. FDA Approves QULIPTA™ (atogepant), the First and Only Oral CGRP Receptor Antagonist Specifically Developed for the Preventive Treatment of Migraine. News release. AbbVie. September 28, 2021. Accessed April 26, 2023. https://news.abbvie.com/news/press-releases/fda-approves-qulipta-atogepant-first-and-only-oral-cgrp-receptor-antagonist-specifically-developed-for-preventive-treatment-migraine.htm?view_id=1531
2. FDA Approves QULIPTA® (atogepant) for Adults With Chronic Migraine. News release. AbbVie. April 23, 2023. Accessed April 26, 2023. https://news.abbvie.com/article_display.cfm?article_id=12576
3.Pozo-Rosich P. Atogepant for the Preventive Treatment of Migraine Among Participants With Episodic Migraine With Prior Treatment Failure: Results From the ELEVATE Trial. Presented at: 2023 AAN Annual Meeting; April 22-27, Boston, Massachusetts. Abstract 007. Emerging Science session.