Migraine attacks are painful events that can cause many unpleasant symptoms, inhibiting a person’s ability to engage in everyday activities. Research is ongoing to find the best ways to help people who experience migraine attacks. A recent study found that administering the medication ubrogepant during the prodrome, or onset, phase of a migraine may greatly improve normal functioning abilities and reduce activity limitations. This study aimed to investigate how using ubrogepant during the prodromal phase of a migraine could enhance functional outcomes, as this phase can occur up to 2 days before the headache-like stage begins.
The study, published in Neurology, was an analysis of the PRODROME trial, a double-blind, randomized, placebo-controlled crossover trial conducted at 73 different sites across the United States. Participants in the trial were split into two groups, with one group receiving the placebo during the first prodrome event and ubrogepant during the second event, and vice versa. Eligible participants had a history of migraine for at least a year and were able to identify prodrome symptoms. The analysis included data from 477 participants and compared patient-reported outcomes related to taking ubrogepant versus a placebo.
Results showed that participants who received ubrogepant were more likely to function normally within 2 hours of taking the medication and experienced fewer activity limitations at 24 hours post-treatment compared to those who received the placebo. Additionally, more participants reported satisfaction with the ubrogepant treatment. The study aimed to measure function ability over a 48-hour period, medication satisfaction and activity limitations over 24 hours, and benefits at the time of assessments, determining ubrogepant’s efficacy during onset phases of migraines.
While the study demonstrated the superiority of ubrogepant over the placebo in improving patient-reported outcome measures, there were limitations to consider. The majority of participants were white females, potentially limiting the generalizability of the results to a more diverse population. Adverse events, such as nausea, were more common among participants taking ubrogepant, and there may have been recall bias in the patient-reported outcomes with 24-hour recall times. Future research may explore the mechanisms by which ubrogepant taken during the prodromal phase works and compare its effectiveness to other acute migraine medications.
The study’s findings provide a new potential treatment approach for those experiencing migraine headaches, demonstrating that taking ubrogepant during the prodrome phase could prevent the progression into a full-blown migraine episode and improve symptoms, keeping patients functional. Clinicians may consider advising patients to take abortive medications early on during prodrome symptoms to optimize outcomes and reduce the severity and limitations associated with migraine attacks. More research is needed to further understand prodromal symptoms and determine the best approaches for managing migraine headaches effectively.
