Ubrogepant is Effective in Combination With OnabotulinumtoxinA to Treat Migraine

Ubrogepant is effective when used in combination with onabotulinumtoxinA in patients with self-identified migraine, according to a study published in The Journal of Headache and Pain.

People on preventative treatments for migraine should be offered acute treatments for breakthrough headaches. OnabotulinumtoxinA is often used as a preventative treatment, but data on its use in combination with the small-molecule calcitonin gene-related peptide (CGRP) receptor antagonist ubrogepant for the acute treatment of migraine is limited. Therefore, researchers aimed to evaluate the real-world effectiveness, treatment satisfaction, and acute treatment optimization of ubrogepant (50 mg or 100 mg) in combination with onabotulinumtoxinA in an open-label, 30-day, multiple-attack, observational study (COURAGE). Meaningful pain relief (MPR) and return to normal function (RNF) were assessed at 2 and 4 hours after dosing to measure effectiveness. Overall satisfaction of ubrogepant and ubrogepant in combination with current preventative was also reported. The study was conducted between September 2020 through April 2021 and included 122 participants who reported at least 1 ubrogepant-treated attack while using onabotulinumtoxinA. Of these, 95.9% were female, ubrogepant 100 mg was used by 55.7% of participants, and 50 mg was used by 44.3%.

For the first treated attack, 53.3% (95% CI, 44-62) of participants achieved MPR at 2 hours post-dose. This number increased to 76.2% (95% CI, 68-83) at 4 hours post-dose. RNF was reached by 25.4% (95% CI, 18-34) of participants at 2 hours post-dose and 45.9% (95% CI, 37-55%) at 4 hours post-dose. Over the course of up to 10 ubrogepant-treated attacks, both MPR and RNF remained stable.

After 30 days of real-world use, 69.8% of participants reported satisfaction with ubrogepant alone, and 58.6% reported satisfaction with ubrogepant in combination with their current preventive medication.

Study limitations include the lack of a randomization process. Additionally, the data were self-reported and not confirmed by a health care provider.

Researchers concluded, “Findings suggest that ubrogepant provides relief of migraine symptoms when used to treat migraine attacks in people using onabotulinumtoxinA for preventive treatment of migraine.”

Disclosure: This research was supported by Allergan. Please see the original reference for a full list of disclosures.