Abstract
BackgroundMigraine is a common neurovascular disorder that has a severe impact on the individual daily life. Atogepant (AGN-241689) is an orally ingested, small-molecule drugs belonging to calcitonin gene-related peptide receptor antagonist, which has been initiated for the prophylactic treatment of migraine. However, there is no comprehensive literature to study the efficacy and safety of atogepant for the treatment of migraine. In this article, we present a meta-analysis of the available studies.MethodsMEDLINE, Embase, Cochrane Library and ClinicalTrials.gov were searched before October 20, 2021 for any relevant literature. Eventually, three randomized clinical trials (RCTs) with 2,466 patients were included in our study.ResultsWe pooled 2,466 patients from 3 RCTs and primary outcome was mean monthly migraine days, the secondary endpoints were monthly headache days, acute medication use days per month and ≥ 50% reduction in monthly migraine days, baseline to end of trials. It was found that atogepant (10 mg, 30 mg, 60 mg once a day) led to a significant reduction in monthly migraine days (P < 0.00001, P < 0.00001, P = 0.007), monthly headache days (P < 0.00001, P < 0.00001, P = 0.001), and monthly medication use days (P < 0.00001, P < 0.00001, P = 0.0001), and an increase in the proportion of people with ≥ 50% reduction in monthly migraine days (P = 0.0008, P = 0.02, P = 0.04) in comparison with placebo. Moreover, there were no significant differences (P > 0.05) in outcomes of adverse events between atogepant and placebo.ConclusionsAtogepant has shown good efficacy and safety in the prophylactic treatment of migraine, and further studies are expected.
Highlights
Migraine is a common neurovascular disorder that has a severe impact on the individual daily life
Chronic migraine (CM), is defined as a headache that occurs at least 15 days per month, lasts for more than 3 months and has to present migraine characteristics on at least 8 days per month [6, 7]. When it comes to the management of migraine, two important aspects are acute treatment and preventive treatment
While preventive treatment depends on the frequency and severity of the migraine attack, taking into account the effects of adverse reactions [8]
Summary
MEDLINE, Embase, Cochrane Library and ClinicalTrials.gov were searched before October 20, 2021 for any relevant literature. Three randomized clinical trials (RCTs) with 2,466 patients were included in our study. A meta-analysis was conducted in conformity with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Search strategy We systematically searched MEDLINE, Embase, Cochrane Library database and ClinicalTrials.gov for any relevant clinical trials published before October 20, 2021. Search terms included the following: migraine AND (atogepant OR AGN-241689). The reference lists and discussion sections of the identified studies and meta-analyses were searched for additional studies. After removing duplicate and irrelevant studies, two investigators manually screened each possible article by reading title, abstract, etc., to determine whether the study met the predefined inclusion criteria. Any divarication came to an agreement through enough discussion
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