A short review on atogepant: recently approved first oral calcitonin gene-related peptide receptor antagonist

Abstract

Migraine is the second leading cause of disability in terms of ‘years lived with disability’ and it affects globally about 12% of the general population. Currently available preventive therapies are not specific to migraine. After the discovery of calcitonin gene-related peptide’s (CGRP’s) role in migraine pathophysiology, CGRP receptor antagonist drugs were developed specifically for migraine. Atogepant is the only oral, selective, potent, second-generation CGRP receptor antagonist approved in September 2021 by Food and Drug Administration (FDA) for prophylaxis of episodic migraines and chronic migraines. It acts by blocking the α-CGRP receptor present on the vascular smooth muscle cell membrane of cranial arteries. It has the added advantage of oral administration, less hepatotoxicity, minimal drug–drug interactions (DDIs) with better efficacy, safety, and tolerability profile compared to the other CGRP receptor antagonists. This present review summarizes the physicochemical properties, pharmacokinetics-pharmacodynamics (PK-PD) parameters, uses, and drug-food interactions with the help of available current evidence.