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PO-80 | Real-world effectiveness of atogepant for the preventive treatment of migraine in a cohort of multi -refractory patients: a single center study

Società Italiana per lo studio delle Cefalee (SISC)

Confinia cephalalgica (Milano), 2025

10 participants

Abstract

Background: Migraine is a leading cause of disability. Atogepant, an oral CGRP receptor antagonist, represents a novel option for preventive migraine treatment, yet real-world data remain limited. With our study we aimed to assess the effectiveness and tolerability of Atogepant in a real-world cohort of patients with high-frequency episodic and chronic migraine refractory to multiple preventive therapies.

Methods: We conducted a single-center, prospective observational study. Fourteen adults with chronic migraine who had failed at least three first-line and one second-line preventive therapies were treated with Atogepant 60 mg daily for a minimum of three months.

Results: A significant reduction in monthly migraine days was observed from baseline (median: 15.0) to month 6 (median: 7.0; p < 0.05). Statistically significant improvements were also detected in MIDAS and HIT-6 scores. Mild adverse events occurred in 10 patients; 3 discontinued treatment due to moderate events. No severe adverse reactions were reported.

Conclusion: In this real-world setting, Atogepant demonstrated good effectiveness and tolerability in patients with treatment-resistant high-frequency episodic and chronic migraine. These findings support its clinical utility as an oral preventive option, particularly for patients already treated with other prophylactic therapies for migraine, including anti-CGRP monoclonal antibodies, and who have shown an insufficient response. Larger studies are needed to…

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: 10 participants or records.

How the five levels of evidence work. The level is assigned automatically from the abstract and can be wrong, so check the paper.

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