Real-world Acute Treatment Optimization for Migraine with Ubrogepant: Results from the COURAGE II Study
Stephanie Nahas1, Brittany Mays2, Nicole Naccara3, Cuiwei Wang4, Janette Contreras-De Lama4, Richard Lipton5
1Thomas Jefferson University, 2University of Pennsylvania, 3Abbvie, 4AbbVie, 5Albert Einstein College of Medicine
Objective:
To evaluate real-world optimization of ubrogepant for the acute treatment of migraine when given to participants also taking atogepant using the migraine Treatment Optimization Questionnaire (mTOQ).
Background:
Ubrogepant and atogepant are small-molecule calcitonin gene–related peptide receptor antagonists approved for the acute (ubrogepant) and the preventive (atogepant) treatment of migraine. The COmbining UbRogepAnt and preventives for miGrainE (COURAGE) II study evaluated the real-world effectiveness of ubrogepant in people with migraine also taking atogepant for migraine prevention. Prior reports summarize responses to treated attacks. This report focuses on responses to the 6-Item mTOQ.
Design/Methods:
COURAGE II, a prospective, real-world observational study, enrolled participants aged ≥18 years who self-reported a physician diagnosis of migraine, were being treated concomitantly with atogepant and ubrogepant, and were using the Migraine Buddy application to track migraine activity, medication use, and treatment response. At 30 days, a final electronic questionnaire included the 6-Item migraine Treatment Optimization Questionnaire (mTOQ).
Results:
A total of 352 participants (mean age, 40.7 years) recorded 1614 attacks that were treated with ubrogepant and completed the mTOQ. Based on mTOQ, 67.3% of participants reported quickly returning to normal activity half the time or more; 50.6% reported being pain free half the time or more within 2 hours of taking ubrogepant, and 52.3% reported experiencing pain relief with 1 dose of ubrogepant lasting ≥24 hours half the time or more. Furthermore, 76.4% of participants reported being comfortable enough with ubrogepant to plan daily activities half the time or more. Safety outcomes were consistent with established safety profiles of ubrogepant and atogepant.
Conclusions:
When used with atogepant, acute treatment with ubrogepant over multiple attacks for 30 days was associated with favorable acute treatment optimization, including rapid, sustained pain relief with a single dose, enabling resumption and planning of normal daily activity.
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