Atogepant for the Prevention of Episodic Migraine in Adults: A Systematic Review and Meta-Analysis of Efficacy and Safety

Lattanzi, Simona; Trinka, Eugen; Altamura, Claudia; Giovane, Cinzia Del; Silvestrini, Mauro; Brigo, Francesco; Vernieri, Fabrizio

doi:10.1007/s40120-022-00370-8

Cited by 11 publications

(10 citation statements)

References 57 publications

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“…Two previous meta-analyses (46,47) explored the efficacy and tolerability of atogepant for migraine prophylaxis compared to placebo, reporting contradictory results in relation to treatment tolerability. In agreement with Lattanzi et al ( 46), here we found that orally administrated atogepant was associated with higher odds of TEAEs compared to placebo, and the most common reported events were constipation and nausea.…”

Section: Discussionmentioning

confidence: 99%

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Safety and tolerability of monoclonal antibodies targeting the CGRP pathway and gepants in migraine prevention: A systematic review and network meta-analysis

et al. 2023

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Background Direct comparisons of the tolerability and safety of migraine preventive treatments targeting the calcitonin gene-related peptide pathway are lacking. This study aimed to compare the safety and tolerability of anti-calcitonin gene-related peptide monoclonal antibodies and gepants in migraine prevention. Methods A network meta-analysis of phase 3 randomized controlled trials assessing the safety and tolerability of anti-calcitonin gene-related peptide monoclonal antibodies (erenumab, eptinezumab, fremanezumab, or galcanezumab) and gepants (atogepant, rimegepant) in migraine prevention was performed. Primary outcomes were treatment-emergent adverse events and serious adverse events. Secondary outcomes included any adverse events, adverse events leading to treatment discontinuation and individual adverse events. Results We included 19 randomized controlled trials, comprising 14,584 patients. Atogepant 120 mg (OR 2.22, 95% CI [1.26, 3.91]) and galcanezumab 240 mg (OR 1.63, 95% CI [1.33, 2.00]) showed the largest odds of treatment-emergent adverse events compared to placebo. While eptinezumab 30 mg had greater odds of adverse events leading to treatment discontinuation (OR 2.62, 95% CI [1.03,6.66]). No significant differences in serious adverse events were found between active treatments and placebo. Eptinezumab was associated with the lowest odds of treatment-emergent adverse events and serious adverse events compared to placebo, whereas erenumab was associated with the lowest odds of any adverse events and quarterly fremanezumab with the lowest odds of treatment discontinuation due to adverse events. Conclusion Monoclonal antibodies targeting the calcitonin gene-related peptide pathway and gepants are a safe and well tolerated option for migraine prevention.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Safety and tolerability of monoclonal antibodies targeting the CGRP pathway and gepants in migraine prevention: A systematic review and network meta-analysis

et al. 2023

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“…40 Both atogepant and eptinezumab belong to the class of CGRP-receptor antagonist, have rapid onset of action and may prevent migraine by inhibiting CGRP receptor activation, therefore, reducing the vasodilatation and neurogenic inflammation process. 40 However, there are few differences between atogepant and eptinezumab. Atogepant partially inhibits both mechanosensitive Aδ and C-meningeal nociceptors, whereas anti-CGRP antibody including eptinezumab can only inhibit Aδ fibres.…”

Section: Discussionmentioning

confidence: 99%

“…The efficacy and safety of eptinezumab for migraine prevention was similar to the recently United States Food and Drug Administration (FDA)‐approved drug for preventive treatment of episodic migraine, atogepant. Results from recent meta‐analysis study showed that 10 and 30 mg of atogepant treatment was associated with reduction in mean migraine days from baseline to 12‐week treatment without increasing the incidence of AEs, and therefore, is considered effective and well‐tolerated for prevention of episodic migraine in adults 40 . Both atogepant and eptinezumab belong to the class of CGRP‐receptor antagonist, have rapid onset of action and may prevent migraine by inhibiting CGRP receptor activation, therefore, reducing the vasodilatation and neurogenic inflammation process 40 .…”

Section: Discussionmentioning

confidence: 99%

“…Results from recent meta‐analysis study showed that 10 and 30 mg of atogepant treatment was associated with reduction in mean migraine days from baseline to 12‐week treatment without increasing the incidence of AEs, and therefore, is considered effective and well‐tolerated for prevention of episodic migraine in adults 40 . Both atogepant and eptinezumab belong to the class of CGRP‐receptor antagonist, have rapid onset of action and may prevent migraine by inhibiting CGRP receptor activation, therefore, reducing the vasodilatation and neurogenic inflammation process 40 . However, there are few differences between atogepant and eptinezumab.…”

Section: Discussionmentioning

confidence: 99%

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Efficacy and safety of eptinezumab as preventive treatment for episodic/chronic migraine: A systematic review and meta‐analysis

Siahaan

Hartoyo

Hariyanto

2022

Clin Exp Pharma Physio

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Migraine, the third most common neurological disorders worldwide, can cause significant burden to the patients. Currently, it has been found that calcitonin gene-related peptide (CGRP) has a significant role in pathophysiology of migraine. This study sought to analyse the efficacy and safety of eptinezumab, one of the CGRP-monoclonal antibody as preventive treatment for episodic/chronic migraine. Specific keywords were used to comprehensively go through the potential articles on ClinicalTrials.gov, Europe PMC, Scopus and PubMed databases until April 2022. All published randomized clinical trials (RCTs) on eptinezumab and migraine were gathered. Statistical analysis was conducted by using Review Manager 5.4 and Comprehensive Meta-Analysis version 3 software. There were four RCTs with 2739 migraine patients in the meta-analysis. In terms of efficacy, our analysis revealed that eptinezumab corresponded with higher reduction in monthly migraine days from baseline to week 12 (standardized mean difference, À0.34 [95% confidence interval (CI), À0.41, À0.28], P < 0.00001; I 2 = 0%), higher 75% and 50% migraine responder rate, reduction in rate of migraine on day-1 after dosing, lower headache impact test-6 score on week 4 and week 12. In terms of safety, eptinezumab has comparable adverse events when compared with placebo (risk ratio, 1.01 [95% CI 0.96-1.07], P = 0.63, I 2 = 0%). Further regression analysis also revealed that the association between eptinezumab and each outcomes of interest were not influenced by age, gender, body mass index and duration of migraine. This study proposes that eptinezumab is generally effective and safe for the preventive treatment of episodic or chronic migraine.

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Synthetic Approaches to the New Drugs Approved During 2021

McInturff,

France,

Leverett

et al. 2023

J. Med. Chem.

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Each year, new drugs are introduced to the market, representing structures that have affinity for biological targets implicated in human diseases and conditions. These new chemical entities (NCEs), particularly small molecules and antibody−drug conjugates, provide insight into molecular recognition and serve as potential leads for the design of future medicines. This annual review is part of a continuing series highlighting the most likely process-scale synthetic approaches to 35 NCEs that were first approved anywhere in the world during 2021. ■ SIGNIFICANCEThis publication presents a synopsis of the synthetic approaches to new drugs that were approved in 2021, based on the largest scale of synthesis that has been disclosed in primary literature and/or patents. This provides a view of the practical synthetic methods that are applicable to drug discovery and development and a holistic perspective on the molecular complexity of novel drug molecules and synthetic methods required to manufacture them.

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Atogepant for the Prevention of Episodic Migraine in Adults: A Systematic Review and Meta-Analysis of Efficacy and Safety

Cited by 11 publications

References 57 publications

Safety and tolerability of monoclonal antibodies targeting the CGRP pathway and gepants in migraine prevention: A systematic review and network meta-analysis

Safety and tolerability of monoclonal antibodies targeting the CGRP pathway and gepants in migraine prevention: A systematic review and network meta-analysis

Efficacy and safety of eptinezumab as preventive treatment for episodic/chronic migraine: A systematic review and meta‐analysis

Synthetic Approaches to the New Drugs Approved During 2021

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