Ubrogepant Taken Early May Improve Outcomes in Migraine

TOPLINE:

Compared with placebo, ubrogepant 100 mg taken during the prodrome phase of a migraine attack significantly improves normal functioning and reduces activity limitations over 24 hours.

METHODOLOGY:

• Researchers analyzed the results of the multicenter, randomized, double-blind, placebo-controlled PRODROME trial (2020-2022) to assess patient-reported outcomes after early administration of ubrogepant during the prodrome phase of migraine attacks.
• In total, 518 participants with 2-8 migraine attacks per month and moderate to severe headache received treatment after two qualifying prodrome events over a 60-day period, with symptoms predictive of a headache within 1-6 hours.
• Group A received a placebo following the first prodrome event and 100 mg ubrogepant after the second prodrome event, and Group B received 100 mg ubrogepant after the first prodrome event and placebo after the second prodrome event.
• The outcomes were the ability to function normally over 24 hours, activity limitations, and satisfaction with the medication.

TAKEAWAY:

• The ability to function normally over 24 hours was significantly greater among participants treated with 100 mg ubrogepant after a prodrome event than among those treated with placebo (odds ratio [OR], 1.66; P < .0001).
• Two hours after dosing, a higher proportion of ubrogepant-treated participants reported normal function without any disability (OR, 1.76; P = .0001) compared with placebo-treated participants.
• At 24 hours, 65% of participants treated with ubrogepant vs 48% of those treated with the placebo reported minimal activity limitations (OR, 2.07; nominal P < .0001).
• A greater proportion of participants who took ubrogepant vs placebo expressed satisfaction at both 8 hours (OR, 2.37; P = .0001) and 24 hours (OR, 2.32; nominal P < .0001) after the dose.

IN PRACTICE:

“Based on our findings, treatment with ubrogepant may allow people with migraine who experience early warning signs before a migraine occurs to quickly treat migraine attacks in their earliest stages and go about their daily lives with little discomfort and disruption,” lead author Richard B. Lipton, MD, Albert Einstein College of Medicine, Bronx, New York City, said in a press release.

SOURCE:

The study was published online on August 28, 2024, in Neurology.

LIMITATIONS:

The 24-hour recall periods for outcome measures, except disability, may have introduced recall bias. Functional ability was measured over 48 hours, and satisfaction with the medication and activity limitations were assessed over 24 hours, restricting inferences to these periods. Only participants reliably identifying prodrome symptoms followed by headache were included, limiting generalizability. Varying the treatment for prodrome symptoms between events may have influenced outcomes. The homogeneity of the study population, with 88.1% participants being White and 92.7% being non-Hispanic, may also have affected the applicability of the findings to more diverse populations.

DISCLOSURES:

The study was funded by AbbVie, the maker of ubrogepant. Detailed financial disclosures are included in the original article.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.