Taking Ubrogepant May Prevent Migraines if Taken at First Warning Signs

Richard B. Lipton, MD

Credit: Albert Einstein College of Medicine

Taking the drug ubrogepant at the first signs of a migraine, before a headache starts, may be effective in preventing migraines, according to a new study published in the online issue of Neurology, the medical journal of the American Academy of Neurology.¹ Participants on the medication went about their day with little or no migraine symptoms.

“Migraine is one of the most prevalent diseases worldwide, yet so many people who suffer from this condition do not receive treatment or report that they are not satisfied with their treatment,” said study author Richard B. Lipton, MD, of Albert Einstein College of Medicine in Bronx, New York, and Fellow of the American Academy of Neurology, in a press release. “Improving care at the first signs of migraine, even before headache pain begins, can be a key to improved outcomes.”

Ubrogepant is currently approved to treat acute migraine headaches, with or without warning signs.² It is only supposed to be used for a migraine headache and for patients who do not receive headache relief from acetaminophen, aspirin, or other pain relievers. According to Mayo Clinic, it is not used to prevent migraines and should be taken when headache pain starts and not during the warning signs of migraines.

However, this new study suggests taking ubrogepant during migraine warning signs may actually be more helpful.¹

Investigators conducted a study of 518 participants who had a migraine for ≥ 1 year and 2 – 8 migraine attacks per month in the 3 months before the study. All participants had migraine warning signs with early symptoms of sensitivity to light and sound, fatigue, neck pain or stiffness, or dizziness. The team wanted to evaluate the effectiveness of ubrogepant, a calcitonin gene-related peptide receptor antagonist or CGRP inhibitor, on migraines during the early warning sign stage.

Participants were divided into 2 groups. One group received a placebo for their first set of pre-headache migraine symptoms, followed by taking ubrogepant 100 mg for their second instance of symptoms. The other group received ubrogepant at first and placebo after. Participants were told to treat 2 migraine attacks during 2 months.

Participants filled out a diary to keep track of how their treatments impacted their activity. This was evaluated with a scale of 0 – 5, with 0 meaning “not at all limited – I could do everything’, 1 meaning “a little limited, 2 meaning “somewhat limited,” 3 meaning, “very limited,” and 4 meaning “extremely limited.”

Twenty-four hours after the treatment dose, 65% of people who took ubrogepant reported they were “not at all limited – I could do everything” or “a little limited, compared to 48% participants on placebo.

As early as 2 hours post-medication, people on ubrogepant were 73% more likely to report they had “no disability, able to function normally,” compared to those who took placebo.

Investigators noted that these findings only apply to people with reliable migraine warning symptoms. A limitation highlighted by investigators was that participants recorded their symptoms and medication use in electronic diaries, so there is room for inaccuracies.

“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,” Lipton said. “This could lead to an improved quality of life for those living with migraine.”

References

1. ^{New Study: Drug May Stop Migraines Before Headache Starts. News Wise. August 22, 2024. https://www.newswise.com/articles/view/815939/?sc=dwhr&xy=10023887. Accessed August 27, 2024.}
2. ^{Ubrogepant (Oral Route). Mayo Clinic. https://www.mayoclinic.org/drugs-supplements/ubrogepant-oral-route/side-effects/drg-20481621?p=1. Accessed August 27, 2024.}