CRCP

A meta-analysis of 137 trials of migraine drugs indicates that the newest class of treatments are less effective than the previous generation of triptan drugs in relieving acute headaches. A study from The BMJ indicates that the newest class of migraine drugs—which includes Pfizer’s Nurtec, AbbVie’s Ubrelvy and Eli Lilly’s Reyvow—is less effective in the acute treatment of migraines than a previous class of medicines.What's more, the newer drugs are no more effective in treating migraines than traditional headache remedies such as Tylenol, ibubrofen and aspirin, according to The BMJ's analysis.The study, a meta-analysis of 137 trials that together enrolled nearly 90,000 patients, indicates that the most effective treatments for migraine come from the triptan class. In head-to-head comparisons of the 17 drugs covered in the study, triptans demonstrated the best efficacy within 2 hours of use, led by eletriptan, which also delivered the best-sustained relief over 24 and 48 hours, according to the analysis.Eletriptan was brought to the market by Pfizer in 2002 and sold under the brand name Relpax. The next most effective medicines in providing relief at 2 hours were the following triptans (in order of performance): rizatriptan, sumatriptan and zolmitriptan. Rizatriptan is sold by Organon as Maxalt. GSK sells sumatriptan as Imitrex and AstraZeneca markets zolmitriptan as Zomig.“Triptans are currently widely underused, and access to the most effective triptans should be promoted globally and international guidelines updated accordingly,” the authors wrote. The BMJ analysis also concluded that the newest class of migraine treatments—which are called calcitonin gene-related peptide receptor (CGRP) antagonists—should only be used after traditional headache meds.“While the recent introduction of lasmiditan (Reyvow), rimegepant (Nurtec), and ubrogepant (Ubrelvy) has expanded options for the acute treatment of migraine, the high cost of these newer drugs, along with the substantial adverse effects of lasmiditan, suggest their use as third-line options, after the less expensive, similarly efficacious, second-line options," the authors wrote.While the BMJ study focused on acute treatment of migraines, new CGRP treatments have also been approved as preventatives. Nurtec pills, for example, were approved in 2021 for use every other day to ward off potential migraines. Much hope has been pinned on the effectiveness of CGRP drugs. In 2022, Pfizer spent $11.6 billion in a buyout of Biohaven to gain Nurtec, which rolled up sales of $928 million last year. Meanwhile, Ubrelvy, which was approved in 2019, generated $815 million in sales.Several other CGRPs—all approved in 2018 for the prevention of migraines—also remain formidable. Eli Lilly’s Emgality generated $678 million in sales last year, while Teva’s Ajovy pulled in $435 million and Amgen’s Aimovig collected $303 million. Besides those drugs, Lundbeck's Vyepti won approval in 2020 and generated about $250 million last year.

THURSDAY, Aug. 29, 2024 -- A migraine drug can help stop the devastating headaches in their tracks, allowing sufferers to go about their daily lives with little to no symptoms, a new clinical trial has found. People who took ubrogepant ( Ubrelvy ) were 73% more likely to say they had no disability and were able to function normally within a couple of hours, compared to those who took a placebo, researchers reported Aug. 28 in the journal Neurology . “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,” said researcher Dr. Richard Lipton , vice chair of neurology with the Albert Einstein College of Medicine in Bronx, N.Y. “This could lead to an improved quality of life for those living with migraine,” Lipton added. The clinical trial, funded by the drug’s maker AbbVie, involved 518 patients who’d been suffering two to eight migraine attacks a month. All of the participants regularly experienced signs that a migraine would be starting within the next few hours, such as sensitivity to light and sound, fatigue, neck pain or stiffness, dizziness or a visual aura, researchers said. Ubrogepant is a calcitonin gene-related peptide receptor antagonist, or CGRP inhibitor. These drugs work by blocking a small protein that plays a key role in pain transmission. Participants were randomly provided either a placebo pill or a 100-milligram ubrogepant tablet, and told to take them when they felt their next migraine coming. The participants then were given either placebo or ubrogepant -- whichever they didn’t get during the first round -- and asked to take the pill prior to the next migraine attack. About 24 hours after taking the pill, 65% of those who took ubrogepant reported that they had little to no migraine symptoms, compared to 48% of those who took a placebo. “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,” Lipton said in a journal news release. “Improving care at the first signs of migraine, even before headache pain begins, can be a key to improved outcomes,” Lipton added. “Our findings are encouraging, suggesting that ubrogepant may help people with migraine function normally and go about their day.” Whatever your topic of interest, subscribe to our newsletters to get the best of Drugs.com in your inbox.

THURSDAY, June 27, 2024 -- It's a nasty cycle: Chronic migraine sufferers who use too much pain medication sometimes get smacked with rebound headaches. But new research suggests that a medication commonly used to prevent migraines may also help fend off rebound headaches. The study of 755 people with chronic migraine -- meaning 15 or more headache days a month with migraines on eight or more -- found that those who overused pain meds had fewer headache days when taking the migraine prevention drug atogepant (Quilipta). "There is a high prevalence of pain medication overuse among people with migraine as they try to manage what are often debilitating symptoms," explained study author Dr. Peter Goadsby , from King's College London. "However, medication overuse can lead to more headaches called rebound headaches, so more preventive treatments treatments are needed." Two-thirds of the participants, who reported their headache and medication history, met the criteria for medication overuse. That means they took pain relievers such as aspirin, acetaminophen or non-steroidal anti-inflammatory drugs (NSAIDs) on 15 or more days a month; migraine drugs called triptans or ergots for 10 days or more; or any combination for 10 days or more. On average, participants reported 18 to 19 migraine days a month and using pain meds on 15 to 16 days. For 12 weeks, they were given 30 milligrams (mg) of atogepant twice daily; 60 mg once a day; or a placebo. Atogepant is a calcitonin gene-related peptide receptor antagonist, or CGRP inhibitor. CGRP is a protein that helps trigger migraines. Participants with medication overuse who took atogepant twice a day averaged three fewer migraine days a month and three fewer headache days, compared to participants who took a placebo. Those taking atogepant once a day had two fewer migraine days a month and two fewer headache days compared to the placebo group. Researchers said similar results were seen in participants who were not overusing medications. Among participants with overuse, 45% of those taking atogepant twice a day and 42% who took it once a day had at least a 50% reduction in average monthly migraine days compared to 25% among those taking the placebo, the study found. Researchers said the number of participants who met the criteria for overuse dropped by 62% in the group taking the drug twice a day. It dropped 52% in once-a-day users. "Based on our findings, treatment with atogepant may potentially decrease the risk of developing rebound headache by reducing the use of pain medications," Goadsby said in a journal news release. "This could lead to an improved quality of life for those living with migraine." More research is needed to evaluate the drug's long-term effectiveness and safety. Researchers noted that one limitation of the study is that participants self-reported their headaches and medication use, raising the possibility that some may have not done so accurately. The study was funded by AbbVie, maker of atogepant. The findings were published June 26 in the journal Neurology . Whatever your topic of interest, subscribe to our newsletters to get the best of Drugs.com in your inbox.