Ubrogepant to Treat Acute Migraine in Adults

Abstract

Migraine is a neurobiological headache disorder that affects around 16% of adults in the United States. Medical treatment of mild to moderate migraines include non-prescription non-steroidal anti-inflammatory drugs, acetaminophen, or aspirin and caffeine-containing combination analgesics. Additionally, moderate to severe migraines and those that are mild to moderate that have not responded to analgesics can be treated with triptans, which are drugs specific for migraine treatment. Non-pharmacological treatments include cognitive behavioral therapy and relaxation training. Medications for the prevention of migraines have also been developed since they are more affective in offsetting the symptoms. Ubrogepant’s high specificity and selectivity for calcitonin gene-related peptide (CGRP) sets it apart from certain other drugs, which previously limited the treatment of migraines with or without aura due to their decreased selectivity. The most frequently reported side effects are oropharyngeal pain, nasopharyngitis, and headache. Most studies found that participants receiving Ubrogepant were free from pain within 2 h when compared to placebo. Patients taking Ubrogepant should avoid taking it when pregnant or with end stage renal disease. In summary, Ubrogepant has good tolerability and an overall favorable safety profile. It appears to hold promise for the acute treatment of migraines with or without aura in adults.

Gepants, calcitonin gene-related peptide antagonists, for abortive treatment of migraine: current status

“…36 Recent studies on mechanistic investigations in both in vitro and in vivo models support liver safety of ubrogepant and reported that it has lower potential to cause hepatotoxicity than has been observed with telcagepant and MK-3207. 35,37,38 It has also been reported that ubrogepant use is not associated medication overuse headache. 31,33…”

“…Its safety and effectiveness in pediatric patients have not been established. 34,35 In pharmacokinetic studies, no clinically significant pharmacokinetic differences were observed between elderly and younger patients. Dosage adjustment is recommended for patients with severe hepatic impairment but not in patients with mild to moderate hepatic impairment.…”

“…On the other hand, dose adjustment is recommended for patients with severe renal impairment as well. [34][35][36] It can be administered with or without food; however, second tablet should not be taken within 24 hrs if migrainer consumed grapefruit juice or taking any medications such as verapamil, ciprofloxacin, fluconazole, cyclosporine. 36 Recent studies on mechanistic investigations in both in vitro and in vivo models support liver safety of ubrogepant and reported that it has lower potential to cause hepatotoxicity than has been observed with telcagepant and MK-3207.…”