Breaking the Migraine Cycle: Ubrogepant Shakes Up Treatment Approach
Alternative migraine treatment significantly alters traditional migraine management
Migraines are more than just a bad headache. They often bring debilitating symptoms for sufferers, even before a full-blown attack. A medication has made waves in the US, offering relief for these pre-attack symptoms, leading some experts to call it a "paradigm shift."
Initially approved for the acute treatment of migraines in the US, Ubrogepant, known by its brand name Ubrelvy, may also ease symptoms during the prodromal phase. This stage, occurring in around 30 to 50% of cases, can last for hours to days before a migraine attack and comes with troublesome symptoms like fatigue, light sensitivity, neck pain, and heightened sensitivity to noise.
The medication has been in the US market for a few years now, falling under the category of gepants or CGRP receptor antagonists, which work by blocking a crucial messenger involved in migraines. Two similar drugs are available in Europe, with Atogepant being prominent for migraine prevention.
Wiping Away Prodromal Symptoms
For the prodromal phase, there are currently no targeted therapies. That changed with the study of Ubrogepant's approval. In the trial, patients either took a Ubrogepant tablet or a placebo when they sensed an oncoming migraine. The primary focus was on whether the medication could prevent headaches.
Later, a team examined around 500 participants from the original study to check if taking Ubrogepant during the prodromal phase could improve the pre-attack symptoms themselves. They found significant improvements in several areas two to four hours after taking Ubrogepant. For example, about 19.5% of those who took the active ingredient reported improved or vanishing photosensitivity compared to 12.5% who received a placebo. Similarly, neck pain improved in about 29% of the Ubrogepant group versus about 19% in the placebo group.
Some experts, like Christian Maihöfner, head physician of the Neurological Clinic at the Klinikum Fürth, find these medications very effective. However, it's important to note that this study's primary intention was to prevent migraine headaches rather than prodromal symptoms.
An Emphasis on Early Intervention
The study found minimal side effects like nausea, fatigue, or dizziness, with no severe side effects reported. The next step: studies solely focused on preventing prodromal symptoms, according to the research team.
The potential for targeting the prodromal phase has experts like Hartmut Göbel, chief physician of the pain clinic in Kiel, excited. For Göbel, it signifies a "paradigm shift," moving away from acute treatment during the pain phase towards interventions in the early stages of migraines. Whether this approach will become standard practice hinges on further, comprehensive studies.
Source: ntv.de, Walter Willems, dpa
- Migraines
- Health
- Disease
- Medication
[1] European Medicines Agency, accessed May 12, 2023: https://www.ema.europa.eu/en/medicines/human/PAR/ubrogepant
[2] U.S. Food and Drug Administration, accessed May 12, 2023: https://www.fda.gov/drugs/information-drug-class/drug-information-ubrogepant-oral-tablet
- The study of Ubrogepant, a medication used for the acute treatment of migraines, has shown significant improvements in pre-attack symptoms during the prodromal phase, which can last for hours to days before a migraine attack.
- The potential for targeting the prodromal phase of migraines is exciting for experts like Hartmut Göbel, chief physician of the pain clinic in Kiel, as it signifies a shift away from acute treatment during the pain phase towards interventions in the early stages of migraines.
- With minimal side effects like nausea, fatigue, or dizziness, and no severe side effects reported, future studies will focus solely on preventing prodromal symptoms, according to the research team, with the aim of making early intervention for migraines a standard practice.
