Atogepant, a groundbreaking drug for migraine prevention, is poised to be introduced into the NHS. Recommended by the National Institute for Health and Care Excellence (NICE), Atogepant aims to prevent both episodic and chronic migraine attacks in individuals experiencing at least four migraine days monthly or those for whom previous preventative treatments have failed.
Migraine, a complex neurological disorder affecting approximately 10 million people in the UK, manifests in severe, recurring headaches exacerbated by physical activity and often accompanied by debilitating symptoms such as aura, light and sound sensitivity, nausea, and vomiting. Chronic migraine, affecting about 1% of the population, involves 15 or more headache days per month, with at least eight exhibiting migraine characteristics.
Until now, migraine prevention options have primarily involved blood pressure drugs or anticonvulsants, which many patients discontinue due to ineffectiveness or adverse effects like dizziness, fatigue, and impaired speech. However, Atogepant, a calcitonin-gene related peptide (CGRP) receptor antagonist, has been specifically developed to target migraines.
CGRP, a protein elevated during migraines, is believed to contribute to headache development. By blocking the CGRP receptor, Atogepant prevents its activation, effectively stopping migraines. It is the first oral daily treatment approved for both episodic and chronic migraines that targets the CGRP protein, with other treatments requiring injections.
Clinical trials have demonstrated Atogepant’s safety and efficacy in preventing episodic and chronic migraines. The Advance trial showed a significant reduction in migraine days per month compared to placebo for all Atogepant doses. Similarly, the Progress trial found both daily 60mg and twice-daily 30mg dosages effectively reduced migraine days in chronic migraine sufferers.
A third trial, 302-LTS, confirmed Atogepant’s consistent effectiveness in reducing migraine attacks over a year. Side effects were generally mild, with constipation, upper respiratory infections, and nausea being the most common (affecting more than 5% of participants).
NICE recommends Atogepant as a once-daily 60mg tablet. Its oral administration and ability to be discontinued promptly make it a convenient and flexible treatment option for migraine patients. Atogepant expands treatment choices for migraine sufferers, particularly those seeking an alternative to injections or daily tablets.
While it is challenging to predict individual responses to Atogepant, its introduction offers new hope and potential quality-of-life improvements for migraine sufferers.
