Summary

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• Qulipta (atogepant) is indicated for the preventive treatment of migraine in adults.
• This summary is based on the review of six systematic reviews/meta-analyses. ^[1-6]
• Reduction in Monthly Migraine Days: Atogepant significantly reduced mean monthly migraine days compared to placebo across doses of 10 mg, 30 mg, and 60 mg, with mean differences (MD) of -1.16 (95% CI -1.60 to -0.73), -1.15 (95% CI -1.54 to -0.76), and -1.20 (95% CI -2.18 to -0.22) respectively. 4. 50% Response Rate: Atogepant showed a significant increase in the proportion of individuals achieving a ≥50% reduction in monthly migraine days compared to placebo, with p-values ranging from 0.0008 to 0.04 depending on the dose.
• Reduction in Acute Medication Days: Atogepant effectively reduced monthly acute medication use days, with p-values ranging from <0.00001 to 0.0001 depending on the dose.
• Adverse Events (AEs): Atogepant 10 mg, 30 mg, and 60 mg doses showed no significant differences in overall AEs compared to placebo. Higher doses (30 mg and 60 mg) were associated with increased risk of constipation (RR 5.19 and 4.92, respectively) and nausea (RR 2.73 for 60 mg). Other CGRP antagonists, such as galcanezumab 240 mg and quarterly fremanezumab 675 mg, also showed significant differences in AEs compared to placebo.
• Serious Adverse Events (SAEs) and Discontinuation due to AEs: No significant differences in SAEs or treatment discontinuation due to AEs between atogepant and placebo. Similar findings were observed for other CGRP antagonists, except for eptinezumab 30 mg, which had greater odds of discontinuation due to AEs (OR 2.62, 95% CI [1.03, 6.66]).
• Episodic Migraine and Demographics: Atogepant was specifically evaluated for episodic migraine prevention in a population with a mean age of 41.0 years and a high proportion of women (87.7%). Other CGRP antagonists were evaluated across both episodic and chronic migraine populations, with no significant differences reported for specific subgroups.