Media release

From: Springer Nature

Health: Migraine treatment eases symptoms before onset

A drug to treat migraine, ubrogepant, is also found to reduce common non-headache symptoms that occur in the hours preceding a migraine headache, according to the results of a large phase three clinical trial published in Nature Medicine. The findings suggest that ubrogepant may be the first acute treatment for the symptoms that occur before migraine, which have a considerable impact on daily function.

Several symptoms can occur before a migraine headache, including aura and premonitory (prodromal) symptoms — also known as early-onset symptoms — such as sensitivity to light and sound, nausea, neck pain and dizziness. Although most migraine research has focused on treating headache, no treatments have shown efficacy to alleviate early premonitory symptoms that often last for hours and can cause considerable dysfunction for people with migraine. Ubrogepant is a drug that blocks the CGRP receptor on neurons, which are responsible for the transmission of pain, but its potential ability to treat premonitory symptoms of migraine was unclear.

Peter Goadsby and colleagues analysed the effectiveness of ubrogepant as a treatment for premonitory symptoms in 438 participants 18–75 years of age with at least a 1-year history of migraine. Participants were split into two groups for a double-blind study, and took a 100-milligram dose of either ubrogepant or a placebo once initial premonitory symptoms started during which the participant was confident a headache would follow within 1–6 hours. During a second prodromal event at least 7 days later, participants took the opposite treatment (ubrogepant or placebo). Goadsby and colleagues found that when participants received ubrogepant, they self-reported improvements in their ability to concentrate 1 hour after treatment, reduced sensitivity to light 2 hours after treatment, and reduced fatigue and neck pain after 3 hours, compared with the placebo-treated group. Dizziness and sensitivity to sound symptoms were also reduced in ubrogepant-treated participants between 4 and 24 hours after treatment.

These findings suggest that ubrogepant may be an effective treatment for common premonitory symptoms, with improvements beginning possibly as early as one hour after dosing. However, additional studies specifically designed to evaluate the effect of acute treatment on prodromal symptoms are needed.