A drug to treat headaches, atogepant, is also effective at decreasing migraine days in adults with chronic migraine, research has suggested.
The study, published in the journal Neurology, has argued that atogepant can be used as a preventive measure in people overusing acute migraine medications such as triptans, ergots and simple analgesics.
It is estimated that between 1.4% to 2.2% of the global population experience chronic migraine, with many having at least 15 days a month of headache regularly.
People with chronic migraine often report significant headache-related disability and a low quality of life. Medication overuse is associated with a higher intensity of headache/migraine pain, and worse pain relief outcomes over a 24-hour period. This can often result in what is known as ‘rebound headache’ once the medication wears off.
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Researchers from King’s College London assessed how effective atogepant could be at preventing chronic migraine both in people who overuse acute medication, as well as those who don’t.
A total of 755 adults aged 18+ were recruited from 142 sites globally, with 500 (66.2%) meeting the criteria for acute medicine overuse.
All participants were then randomised into one of three groups. One group was asked to take 30mg of atogepant twice daily. A second took 60mg of atogepant once daily, and then the third was a placebo control group.
Participants were asked to self-report the regularity of their migraine over three months, while still using their current medications.
At the end of the trial period, researchers found that, of the participants who overused acute medication, 44.7% of those in the 30mg group, and 41.8% of those in the 60mg group saw a more than 50% reduction in the number of days that they experienced migraines in a given month. This compared with 24.9% of those people who received the placebo.
Of those participants who didn’t overuse their medication, 39.1% of the 30mg group, and 39.5% of the 60mg group achieved a more than 50% reduction, compared with 28.6% in the placebo arm.
“There is a high prevalence of pain medication overuse among people with migraine as they try to manage what are often debilitating symptoms, however, medication overuse can lead to more headache called rebound headache; this problem is ideally treated by prevention,” said Professor Peter Goadsby, professor of neurology at King’s Institute of Psychiatry, Psychology & Neuroscience and the study’s lead author.
“Based on our findings, treatment with atogepant could potentially decrease the risk of developing rebound headache by reducing the use of pain medications, and could lead to an improved quality of life for those living with migraine,” he added.
The researchers intend to conduct further investigations assessing the long-term effectiveness and safety of atogepant. In the UK, the National Institute for Health and Care Excellence recently recommended it for the prevention of chronic and episodic migraine.
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