PO-75 | Network meta-analysis comparing efficacy and safety outcomes of atogepant, rimegepant, and galcanezumab in patients with episodic migraine after including CHALLENGE-MIG Trial
Abstract
Background: Network meta-analysis of atogepant (Ato) relative to rimegepant (Rime) and galcanezumab (Galc) after inclusion of the CHALLENGE-MIG trial for efficacy and safety outcomes in episodic migraine (EM) patients.
Methods: The NMA included 5 randomized, controlled trials for the preventive treatment of EM (ADVANCE [Ato 60 mg], BHV3000-305 [Rime 75 mg], EVOLVE-1, EVOLVE-2 [Galc 120 mg], and CHALLENGE-MIG [Rime 75 mg, Galc 120 mg]). A fixed-effects model was chosen to compare the efficacy and safety of Ato versus Rime, Galc based on model fit statistics. Efficacy results at 12 weeks are presented as odds ratio (OR) or estimates of mean difference with corresponding 95% confidence intervals (CI). Safety results are presented as hazard ratio and 95% CI.
Results: After including CHALLENGE-MIG, the NMA showed Ato significantly increased the odds of achieving 50% RR in MMD compared to Rime (OR 2.29 (95% CI 1.43-3.66)), Galc (1.68 (1.07-2.64)), and placebo (Pbo) (3.80 (2.55-5.67)). Ato showed numerically higher MMD reductions compared to Rime and Galc, and significantly higher reductions compared to Pbo. Ato showed significantly greater reductions in acute medication use days compared to Rime and Pbo, and numerically greater reductions compared to Galc. Ato demonstrated significant improvement in Migraine Specific Quality of Life questionnaire version 2.1 Role Function-Restrictive domain score compared to Rime and Pbo, and numerical improvement compared to Galc. Ato…
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Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid.
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