Study shows: Medication can stop migraines before the headache starts

When taken at the first signs of a migraine, before the headache starts, a drug called ubrogepant may help people with migraines go about their daily lives with few or no symptoms, according to a study published in the August 28, 2024, online issue of. neurology.

The study focused on people with migraines who were able to recognize an impending attack based on early symptoms such as sensitivity to light and noise, fatigue, neck pain or stiffness, or dizziness.

Ubrogepant is a calcitonin gene-related peptide receptor antagonist or CGRP inhibitor. CGRP is a protein that plays a key role in the migraine process.

“Migraine is one of the most common disorders in the world, yet so many people who suffer from this disease do not receive treatment or report dissatisfaction with their treatment,” said study author Richard B. Lipton, MD, of the Albert Einstein College of Medicine in Bronx, New York, and a fellow of the American Academy of Neurology.

“Improved treatment at the first signs of migraine, even before the headache starts, may be the key to better outcomes. Our results are encouraging and suggest that ubrogepant can help people with migraine to function normally and manage their daily lives.”

The study involved 518 participants who had suffered from migraines for at least a year and had two to eight migraine attacks per month in the three months prior to the study. All participants had regular signs that a migraine would start within the next few hours. Participants were asked to treat two attacks within two months.

The researchers divided the participants into two groups. The first group received a placebo when the first symptoms before the headache occurred and 100 milligrams (mg) of ubrogepant when the second symptoms occurred. The second group received ubrogepant when the first symptoms occurred and a placebo when the second symptoms occurred.

Participants rated their activity limitations in their diary using a scale of zero to five, where 0 means “not at all limited – I could do everything,” 1 means “a little limited,” 2 means “somewhat limited,” 3 means “very limited,” and 4 means “extremely limited.”

Twenty-four hours after taking the drug or a placebo, 65% of people who took ubrogepant reported being “not limited at all – I could do everything” or “a little limited,” compared with 48% of people who took the placebo.

The researchers found that people who took the drug were 73% more likely to be “free from disability and able to function normally” just two hours after taking it, compared to people who took the placebo.

“Based on our findings, treatment with ubrogepant could enable migraine sufferers who experience early warning signs before a migraine occurs to quickly treat migraine attacks at their earliest stages and continue to live their daily lives with little discomfort and disruption,” said Lipton. “This could lead to an improved quality of life for migraine sufferers.”

Lipton found that participants were able to reliably predict an impending migraine based on their headache warning symptoms. These results only apply to people with reliable warning symptoms.

A limitation of the study was that participants documented their symptoms and medication use in electronic diaries, so it is possible that some people may not have recorded all information accurately.