PMID- 35705886
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220801
IS  - 2193-8253 (Print)
IS  - 2193-6536 (Electronic)
IS  - 2193-6536 (Linking)
VI  - 11
IP  - 3
DP  - 2022 Sep
TI  - Atogepant for the Prevention of Episodic Migraine in Adults: A Systematic Review 
      and Meta-Analysis of Efficacy and Safety.
PG  - 1235-1252
LID - 10.1007/s40120-022-00370-8 [doi]
AB  - INTRODUCTION: The inhibition of the calcitonin gene-related peptide (CGRP) 
      pathway has attracted interest in pharmacological research on migraine. Atogepant 
      is a potent, selective, orally available antagonist of the CGRP receptor approved 
      as a preventive treatment of episodic migraine. This systematic review with 
      meta-analysis aims to evaluate the efficacy and safety of atogepant for the 
      prevention of episodic migraine in adult patients. METHODS: Randomized, 
      placebo-controlled, single or double-blinded trials were identified through a 
      systematic literature search (December week 4, 2021). Main outcomes included the 
      changes from baseline in monthly migraine days and the incidence of adverse 
      events (AEs) and treatment withdrawal due to AEs. Mean difference (MD) and risk 
      ratio (RR) with 95% confidence intervals (95% CIs) were estimated. RESULTS: Two 
      trials were included, overall enrolling 1550 patients. A total of 408 
      participants were randomized to placebo, 314 to atogepant 10 mg, 411 to atogepant 
      30 mg, and 417 to atogepant 60 mg once daily. The mean age of the patients was 
      41.0 years and 87.7% were women. The reduction in the mean number of migraine 
      days from baseline across the 12-week treatment period was significantly greater 
      among patients treated with atogepant at either the daily dose of 10 mg (MD 
      - 1.16, 95% CI - 1.60 to - 0.73, p < 0.001), 30 mg (MD - 1.15, 95% CI - 1.54 to 
      - 0.76, p < 0.001), or 60 mg (MD - 1.20, 95% CI - 2.18 to - 0.22, p = 0.016) than 
      with placebo. There were no differences in the occurrence of AEs and drug 
      withdrawal due to AEs between atogepant and placebo groups. Constipation was more 
      commonly observed in patients treated with atogepant at 30 mg/day than placebo 
      (RR 5.19, 95% CI 2.00-13.46; p = 0.001). Treatment with atogepant at the daily 
      dose of 60 mg was associated with a higher risk of constipation (RR 4.92, 95% CI 
      1.89-12.79; p = 0.001) and nausea (RR 2.73, 95% CI 1.47-5.06; p = 0.001) than 
      placebo. CONCLUSION: Atogepant is an efficacious and overall well-tolerated 
      treatment for the prevention of episodic migraine in adults.
CI  - (c) 2022. The Author(s).
FAU - Lattanzi, Simona
AU  - Lattanzi S
AUID- ORCID: 0000-0001-8748-0083
AD  - Department of Experimental and Clinical Medicine, Neurological Clinic, Marche 
      Polytechnic University, Via Conca 71, 60020, Ancona, Italy. 
      alfierelattanzisimona@gmail.com.
FAU - Trinka, Eugen
AU  - Trinka E
AD  - Department of Neurology, Christian Doppler Klinik, Paracelsus Medical University, 
      Salzburg, Austria.
AD  - Center for Cognitive Neuroscience, Salzburg, Austria.
AD  - Public Health, Health Services Research and HTA, University for Health Sciences, 
      Medical Informatics and Technology, Hall in Tirol, Austria.
FAU - Altamura, Claudia
AU  - Altamura C
AD  - Headache and Neurosonology Unit, Fondazione Policlinico Campus Bio-Medico of 
      Rome, Rome, Italy.
FAU - Del Giovane, Cinzia
AU  - Del Giovane C
AD  - Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland.
FAU - Silvestrini, Mauro
AU  - Silvestrini M
AD  - Department of Experimental and Clinical Medicine, Neurological Clinic, Marche 
      Polytechnic University, Via Conca 71, 60020, Ancona, Italy.
FAU - Brigo, Francesco
AU  - Brigo F
AD  - Division of Neurology, "Franz Tappeiner" Hospital, Merano, BZ, Italy.
FAU - Vernieri, Fabrizio
AU  - Vernieri F
AD  - Headache and Neurosonology Unit, Fondazione Policlinico Campus Bio-Medico of 
      Rome, Rome, Italy.
LA  - eng
PT  - Journal Article
DEP - 20220615
PL  - New Zealand
TA  - Neurol Ther
JT  - Neurology and therapy
JID - 101637818
PMC - PMC9338214
OTO - NOTNLM
OT  - Atogepant
OT  - Efficacy
OT  - Migraine
OT  - Prevention
OT  - Tolerability
EDAT- 2022/06/16 06:00
MHDA- 2022/06/16 06:01
PMCR- 2022/06/15
CRDT- 2022/06/15 23:36
PHST- 2022/04/25 00:00 [received]
PHST- 2022/05/25 00:00 [accepted]
PHST- 2022/06/16 06:00 [pubmed]
PHST- 2022/06/16 06:01 [medline]
PHST- 2022/06/15 23:36 [entrez]
PHST- 2022/06/15 00:00 [pmc-release]
AID - 10.1007/s40120-022-00370-8 [pii]
AID - 370 [pii]
AID - 10.1007/s40120-022-00370-8 [doi]
PST - ppublish
SO  - Neurol Ther. 2022 Sep;11(3):1235-1252. doi: 10.1007/s40120-022-00370-8. Epub 2022 
      Jun 15.