| Abstract [eng] |
Migraine is a prevalent chronic neurological condition, characterized by recurrent episodes of severe headache, which significantly impair the quality of life. The cornerstones of management are effective prophylaxis and appropriate symptomatic treatment during attacks. Atogepant, a small molecular weight antagonist of calcitonin gene-related peptide, is administered orally in tablet form and is used to reduce the frequency of migraine attacks. This medication was included in the reimbursement system in Lithuania in 2024; however, no real-world evidence regarding its use has yet been published. The aim of this study is to evaluate the tolerability and efficacy of atogepant in reducing migraine frequency. The objectives were as follows: 1. To assess changes in monthly migraine days for all patients, compare the change between patients with episodic and chronic migraine, as well as patients who have been treated with specific prophylactic therapy before and naïve patients; 2. To assess frequency of acute medication use; 3. To identify the most common adverse effects; 4. To identify the most common reasons for treatment discontinuation. A retrospective study was conducted involving 102 patients aged 18 and above who were treated with atogepant at the Neurology Department “Meliva” – “Kardiolitos klinikos” between November of 2024 and October of 2025. The efficacy analysis included 64 patients who completed twelve consecutive weeks of treatment. Statistical analyses were conducted using IBM SPSS Statistics 31 software, the methods applied included the Wilcoxon, Mann-Whitney and Kruskal-Wallis tests, as well as Pearson χ² test, Fisher‘s exact test, and Spearman‘s correlation analysis. After twelve weeks of treatment, the number of monthly migraine days decreased by 6, the number of days requiring acute medication was similarly reduced by 6, the number of days with triptan use was reduced by 3,5. Atogepant was equally effective for patients with chronic and episodic migraine, as well as in those for whom it was prescribed as a first-line specific preventive treatment, those in whom prior specific prophylactic therapy had been ineffective, and those who had previously responded to other preventive treatments. Adverse effects were reported by 32.4% of patients, most common being constipation (18.63%) and nausea (10.78%). 32.4% of patients discontinued treatment, most frequently due to insufficient effectiveness (16.67%) and adverse effects (12.75%). In conclusion, atogepant appears to be effective and generally well-tolerated option for migraine prophylaxis. Its effectiveness does not depend on demographic or clinical characteristics of the patient, suggesting its suitability for a broad population of patients with frequent episodic and chronic migraine. |
