Atogepant for migraine prevention: a meta-analysis of safety and efficacy in adults
BackgroundMigraine is a neurological condition marked by frequent headaches, which tends to be accompanied by nausea and vomiting in severe instances. Injectable therapies for migraine, such as monoclonal antibodies that target calcitonin gene-related peptide (CGRP), have proven to be effective and...
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Frontiers Media S.A.
2024-09-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2024.1468961/full |
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| author | Adarsh Raja Rabia Asim Muhammad Hamza Shuja Sandesh Raja Tazheen Saleh Muhammad Simran Bajaj Abdul Hadi Ansari Hamza Ali Iffat Ambreen Magsi Muhammad Hammad Faridi Hamza Ali Hasnain Sheikh Muhammad Junaid Imran Muhammad Ahmed Muhammad Sohaib Asghar Muhammad Sohaib Asghar |
| author_facet | Adarsh Raja Rabia Asim Muhammad Hamza Shuja Sandesh Raja Tazheen Saleh Muhammad Simran Bajaj Abdul Hadi Ansari Hamza Ali Iffat Ambreen Magsi Muhammad Hammad Faridi Hamza Ali Hasnain Sheikh Muhammad Junaid Imran Muhammad Ahmed Muhammad Sohaib Asghar Muhammad Sohaib Asghar |
| author_sort | Adarsh Raja |
| collection | DOAJ |
| description | BackgroundMigraine is a neurological condition marked by frequent headaches, which tends to be accompanied by nausea and vomiting in severe instances. Injectable therapies for migraine, such as monoclonal antibodies that target calcitonin gene-related peptide (CGRP), have proven to be effective and safe. While various oral drugs are available, none have been developed for migraines. Patients prefer oral therapies because they are easier to use, making atogepant, an orally accessible small-molecule CGRP receptor antagonist, a possible alternative.ObjectivesThis systematic review and meta-analysis compared the safety and effectiveness of atogepant with placebo in treating migraine.MethodsAdhering to the PRISMA guidelines, we meticulously gathered randomized controlled trials (RCTs) from databases including the Cochrane Library, PubMed, Science Direct, and ClinicalTrials.gov. Studies comparing atogepant with placebo and reporting monthly migraine days (MMDs) as the primary outcome along with secondary outcomes such as monthly headache days and acute medication use days were included. Two independent reviewers conducted the data extraction and quality assessment. Statistical analyses were carried out using RevMan, utilizing risk ratios for dichotomous outcomes and mean differences for continuous outcomes, and a random-effects model.ResultsOur primary outcome was the change in MMDs over 12 weeks, which showed a significant reduction with atogepant at dosages of 10, 30, and 60 mg. Secondary outcomes, such as monthly headache days, proportion of patients achieving a ≥ 50% reduction in MMDs, acute medication use days, and patient-reported outcomes, consistently showed that atogepant outperformed placebo, highlighting its effectiveness in reducing the migraine burden.ConclusionHigher doses of atogepant are more effective in lowering migraine and headache-related days and increasing quality of life metrics. However, this is accompanied by an increased incidence of adverse events, suggesting the need for careful dose optimization to balance the benefits and risks.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=563395. Unique Identifier: CRD42024563395. |
| format | Article |
| id | doaj-art-8916e16ca8244a7fa4b1c5ba21660cfa |
| institution | DOAJ |
| issn | 1664-2295 |
| language | English |
| publishDate | 2024-09-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj-art-8916e16ca8244a7fa4b1c5ba21660cfa2025-08-20T03:06:17ZengFrontiers Media S.A.Frontiers in Neurology1664-22952024-09-011510.3389/fneur.2024.14689611468961Atogepant for migraine prevention: a meta-analysis of safety and efficacy in adultsAdarsh Raja0Rabia Asim1Muhammad Hamza Shuja2Sandesh Raja3Tazheen Saleh Muhammad4Simran Bajaj5Abdul Hadi Ansari6Hamza Ali7Iffat Ambreen Magsi8Muhammad Hammad Faridi9Hamza Ali Hasnain Sheikh10Muhammad Junaid Imran11Muhammad Ahmed12Muhammad Sohaib Asghar13Muhammad Sohaib Asghar14Department of Internal Medicine, Shaheed Mohtarma Benazir Bhutto Medical College Lyari, Karachi, PakistanDepartment of Internal Medicine, Shaheed Mohtarma Benazir Bhutto Medical College Lyari, Karachi, PakistanDepartment of Internal Medicine, Dow University of Health Sciences, Karachi, PakistanDepartment of Internal Medicine, Dow University of Health Sciences, Karachi, PakistanDepartment of Internal Medicine, Shaheed Mohtarma Benazir Bhutto Medical College Lyari, Karachi, PakistanDepartment of Internal Medicine, Shaheed Mohtarma Benazir Bhutto University, Larkana, PakistanDepartment of Internal Medicine, Shaheed Mohtarma Benazir Bhutto Medical College Lyari, Karachi, PakistanDepartment of Internal Medicine, Shaheed Mohtarma Benazir Bhutto Medical College Lyari, Karachi, PakistanDepartment of Internal Medicine, Shaheed Mohtarma Benazir Bhutto Medical College Lyari, Karachi, PakistanDepartment of Internal Medicine, Shaheed Mohtarma Benazir Bhutto Medical College Lyari, Karachi, PakistanDepartment of Internal Medicine, Shaheed Mohtarma Benazir Bhutto Medical College Lyari, Karachi, PakistanDepartment of Internal Medicine, Shaheed Mohtarma Benazir Bhutto Medical College Lyari, Karachi, PakistanDepartment of Internal Medicine, Shaheed Mohtarma Benazir Bhutto Medical College Lyari, Karachi, PakistanDepartment of Internal Medicine, AdventHealth, Sebring, FL, United StatesDepartment of Internal Medicine, Mayo Clinic, Rochester, MN, United StatesBackgroundMigraine is a neurological condition marked by frequent headaches, which tends to be accompanied by nausea and vomiting in severe instances. Injectable therapies for migraine, such as monoclonal antibodies that target calcitonin gene-related peptide (CGRP), have proven to be effective and safe. While various oral drugs are available, none have been developed for migraines. Patients prefer oral therapies because they are easier to use, making atogepant, an orally accessible small-molecule CGRP receptor antagonist, a possible alternative.ObjectivesThis systematic review and meta-analysis compared the safety and effectiveness of atogepant with placebo in treating migraine.MethodsAdhering to the PRISMA guidelines, we meticulously gathered randomized controlled trials (RCTs) from databases including the Cochrane Library, PubMed, Science Direct, and ClinicalTrials.gov. Studies comparing atogepant with placebo and reporting monthly migraine days (MMDs) as the primary outcome along with secondary outcomes such as monthly headache days and acute medication use days were included. Two independent reviewers conducted the data extraction and quality assessment. Statistical analyses were carried out using RevMan, utilizing risk ratios for dichotomous outcomes and mean differences for continuous outcomes, and a random-effects model.ResultsOur primary outcome was the change in MMDs over 12 weeks, which showed a significant reduction with atogepant at dosages of 10, 30, and 60 mg. Secondary outcomes, such as monthly headache days, proportion of patients achieving a ≥ 50% reduction in MMDs, acute medication use days, and patient-reported outcomes, consistently showed that atogepant outperformed placebo, highlighting its effectiveness in reducing the migraine burden.ConclusionHigher doses of atogepant are more effective in lowering migraine and headache-related days and increasing quality of life metrics. However, this is accompanied by an increased incidence of adverse events, suggesting the need for careful dose optimization to balance the benefits and risks.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=563395. Unique Identifier: CRD42024563395.https://www.frontiersin.org/articles/10.3389/fneur.2024.1468961/fullatogepantCGRPmigraineheadachemeta-analysis |
| spellingShingle | Adarsh Raja Rabia Asim Muhammad Hamza Shuja Sandesh Raja Tazheen Saleh Muhammad Simran Bajaj Abdul Hadi Ansari Hamza Ali Iffat Ambreen Magsi Muhammad Hammad Faridi Hamza Ali Hasnain Sheikh Muhammad Junaid Imran Muhammad Ahmed Muhammad Sohaib Asghar Muhammad Sohaib Asghar Atogepant for migraine prevention: a meta-analysis of safety and efficacy in adults Frontiers in Neurology atogepant CGRP migraine headache meta-analysis |
| title | Atogepant for migraine prevention: a meta-analysis of safety and efficacy in adults |
| title_full | Atogepant for migraine prevention: a meta-analysis of safety and efficacy in adults |
| title_fullStr | Atogepant for migraine prevention: a meta-analysis of safety and efficacy in adults |
| title_full_unstemmed | Atogepant for migraine prevention: a meta-analysis of safety and efficacy in adults |
| title_short | Atogepant for migraine prevention: a meta-analysis of safety and efficacy in adults |
| title_sort | atogepant for migraine prevention a meta analysis of safety and efficacy in adults |
| topic | atogepant CGRP migraine headache meta-analysis |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2024.1468961/full |
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