Results of the ELEVATE trial demonstrating the safety and efficacy of oral atogepant for the prevention of treatment-resistant episodic migraine prevention have now been published.
days compared to placebo in adults with episodic migraine in whom two to four classes of oral preventive medications had previously failed.gene-related peptide receptor antagonist is approved in the US as a preventive agent for both episodic and chronic migraine, but its efficacy and safety in patients in whom conventional oral preventive migraine treatments have failed has not been evaluated in a dedicated trial, until now.
A total of 315 patients were randomly allocated in a 1:1 ratio to receive atogepant 60 mg or placebo once daily for 12 weeks; of these, 313 participants received at least one dose of assigned intervention. The least-squares mean changes from baseline in mean monthly migraine days across 12 weeks were −1.9 with placebo vs −4.2 with atogepant. The least-squares mean difference from placebo was −2.4 days with atogepant and nausea , while the placebo group had a higher rate of nasopharyngitis .
"Intriguingly, previous research indicates that, the higher the number of past treatment failures, the greater the efficacy of anti-CGRP medications for preventive treatment," Jiying Zhou, MD, PhD, and coauthors with the Department of Neurology, First Affiliated Hospital of Chongqing Medical University in China, wrote.
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