Patient Care brings primary care clinicians a lot of medical news every day—it’s easy to miss an important study. The Daily Dose provides a concise summary of one of the website's leading stories you may not have seen.
Last week, we reported on findings from a study published in the journal Cephalalgia that examined the effects of preventive migraine treatment with atogepant compared with placebo on patient-reported quality of life (QoL) and functioning.
The study
Researchers analyzed patient reported outcome measures (PROMS) from the ADVANCE, PROGRESS, and ELEVATE trials. They assessed the effect of atogepant 60 mg vs placebo on 3 routinely used and complementary measures of migraine related QoL and functioning among the different populations of individuals with migraine enrolled in the 3 randomized controlled trials mentioned. Although there is some overlap among the instruments, each quantifies distinct domains:
Migraine-Specific Quality of Life questionnaire version 2.1 (MSQv2.1)
Headache Impact Test-6 (HIT-6)
Activity Impairment in Migraine–Diary (AIM-D)
The ADVANCE trial focused evaluated atogepant 60 mg in participants with low-frequency episodic migraine (4 to 8 monthly migraine days [MMD]) and high-frequency episodic migraine with 8 to 12 MMD. In the PROGRESs trial, participants experienced chronic migraine and in ELEVATE atogepant 60 mg was evaluated in adults with episodic migraine in individuals who previously failed 2 to 4 classes of oral preventive treatments.
The findings
Compared with placebo, participants who received atogepant had a greater change from baseline to week 12 in the MSQv2.1 Role Function-Restrictive domain scores (P < .05). This was seen in ADVANCE for low-frequency episodic migraine (least squares mean difference, 12.0; 95% CI, 6.0 to 18.0) and high-frequency episodic migraine (9.9; 95% CI, 3.4 to 16.4), as well as in PROGRESS (6.2; 95% CI, 2.5 to 9.8) and ELEVATE (17.7; 95% CI, 13.1 to 22.3).
The change from baseline to week 12 was also greater for atogepant-treated participants on HIT-6 total scores in all 3 trials: ADVANCE for low-frequency episodic migraine (-4.7; 95% CI, -6.7 to -2.7) and high-frequency episodic migraine (-3.4; 95% CI, -5.5 to -1.2); PROGRESS (-2.8; 95% CI, -4.1 to -1.4), and ELEVATE (-6.5; 95% CI, -8.3 to -4.7).
Investigators reported parallel findings for scores on the AIM-D from baseline to week 12 for atogepant vs placebo: ADVANCE (low-frequency episodic migraine: -2.3; 95% CI, -3.9 to -0.7; high-frequency episodic migraine: -4.5; 95% CI, -6.9 to -2.2), PROGRESS (-3.4; 95% CI, 5.3 to -1.5), and ELEVATE (-4.7; 95% CI, -6.4 to -3.1).
Authors' comments
"These results demonstrate the value of preventive treatment with atogepant for reducing migraine-attributed impacts on multiple aspects of daily life, health, and well-being across the spectrum of people with migraine."
