Real-life effectiveness, tolerability, and safety of atogepant: a prospective, observational, multicentre study by the Headache Study Group in Castile-La Mancha.

INTRODUCTION

Migraine is the most frequent reason for neurology consultation and has a significant impact on patients at the professional, social, and financial level. In the past year, atogepant, an oral drug targeting the calcitonin gene-related peptide (CGRP) receptor, has been approved in Spain, and clinical trials have shown that it is a promising option for the treatment of both episodic and chronic migraine.

METHODS

We present a prospective, multicentre, observational study of 136 patients with drug-resistant migraine, recruited from seven hospitals in Castile-La Mancha. Our aim was to compare the efficacy of atogepant 60 mg reported in clinical trials with our real-world experience. Data on demographic characteristics, diagnosis, number of monthly migraine days, impact scale scores, adverse reactions, and patient outcomes after 3 months of treatment were gathered and analysed.

RESULTS

Forty percent of patients experienced a ≥ 50% reduction in monthly migraine days compared to baseline. An overall net reduction of -5.7 monthly migraine days was observed. Adverse reactions were reported by 41.9% of patients; and treatment was discontinued due to intolerance before the end of the treatment period in 11.7% of patients.

CONCLUSION

Our findings confirm the effectiveness and safety of atogepant reported in clinical trials, although tolerability is poorer, which could compromise treatment adherence in clinical practice.