Stop headaches before they occur

Ubrogepant, a medication taken when migraine symptoms begin, has shown promising results in a study, allowing sufferers to carry out their daily activities with minimal discomfort.

The study with 518 participants shows that early treatment can significantly reduce the disabilities associated with migraines and thus improve the quality of life of those affected.

When taken at the first signs of a migraine, before the headache starts, a drug called ubrogepant may help people with migraines go about their daily lives with few or no symptoms, according to a new study published in the August 28, 2024, online issue of. neurologythe medical journal of the American Academy of Neurology. The study focused on people with migraines who were able to recognize an impending attack based on early symptoms such as sensitivity to light and sound, fatigue, neck pain or stiffness, or dizziness.

Ubrogepant is a calcitonin gene-related peptide receptor antagonist or CGRP inhibitor. CGRP is a protein that plays a key role in the migraine process.

Study results on migraine treatment

“Migraine is one of the most common diseases worldwide, and yet so many people with this condition receive no treatment or report dissatisfaction with their treatment,” said study author Richard B. Lipton, MD, of the Albert Einstein College of Medicine in Bronx, New York, and a Fellow of the American Academy of Neurology. “Improved treatment at the first signs of migraine, even before the headache begins, may be a key to improved outcomes. Our results are encouraging and suggest that ubrogepant can help people with migraine to function normally and manage their daily lives.”

The study involved 518 participants who had suffered from migraines for at least a year and had two to eight migraine attacks per month in the three months prior to the study. All participants had regular signs that a migraine would start within the next few hours. Participants were asked to treat two attacks within two months.

Study design and participant responses

The researchers divided the participants into two groups. The first group received a placebo when the first symptoms before the headache occurred and 100 milligrams (mg) of ubrogepant when the second symptoms occurred. The second group received ubrogepant when the first symptoms occurred and a placebo when the second symptoms occurred.

Participants rated their activity limitations in their diary using a scale of zero to five, where 0 means “not at all limited – I could do everything,” 1 means “a little limited,” 2 means “somewhat limited,” 3 means “very limited,” and 4 means “extremely limited.”

Twenty-four hours after taking the drug or a placebo, 65% of people taking ubrogepant reported feeling “not limited at all – I could do everything” or “a little limited,” compared with 48% of people taking the placebo.

The researchers found that people who took the drug were 73% more likely to say they had “no disability and were able to function normally” just two hours after taking it, compared to people who took the placebo.

Impact and limitations of the study

“Based on our findings, treatment with ubrogepant could enable migraine sufferers who experience early warning signs before a migraine occurs to rapidly treat migraine attacks at their earliest stages and continue to live their daily lives with little discomfort and disruption,” Lipton said. “This could lead to an improved quality of life for migraine sufferers.”

Lipton found that participants were able to reliably predict an impending migraine based on their headache warning symptoms. These results only apply to people with reliable warning symptoms.

A limitation of the study was that participants recorded their symptoms and medication use in electronic diaries, so it is possible that some people may not have recorded all information accurately.

Reference: 28 August 2024, neurology.

The study was funded by AbbVie, the manufacturer of ubrogepant.