Effectiveness of atogepant in migraine with and without medication overuse: Pooled real-world analysis of two independent clinical cohorts
Abstract
Background: Medication-overuse headache (MOH) is common in treatment-resistant chronic migraine and may complicate preventive management. The aim of this study was to evaluate the short-term effectiveness of atogepant 60 mg once daily in a pooled real-world population of patients with migraine, including treatment-resistant chronic migraine, and to explore whether baseline MOH influenced treatment response.
Methods: This pooled observational study combined two independent real-world cohorts of patients treated with atogepant 60 mg once daily for migraine prevention. The database included 78 patients, with short-term follow-up recorded at 12 weeks in one cohort and at 3 months in the other. Monthly migraine days (MMD), monthly symptomatic medication use, Migraine Disability Assessment (MIDAS), Headache Impact Test-6 (HIT-6), and treatment documentation were harmonized. Effectiveness was analyzed in the pooled population, while exploratory comparisons were performed according to baseline medication-overuse headache (MOH) status.
Results: The pooled database included 78 patients, and paired MMD measurements were available for 73. Median MMD decreased from 13.0 [10.0-20.0] to 4.0 [3.0-8.0], with a median reduction of 7.0 [6.0-11.0] days/month (p < 0.001). A reduction of at least 50% was achieved by 54/73 patients (74.0%). MIDAS, HIT-6, and monthly symptomatic medication use also improved significantly (all p < 0.001). MOH status was available for 77 patients: 24 had MOH and 53…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 78 participants or records.
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