Allergan plc (NYSE:AGN) today announced that positive results from ACHIEVE II (UBR-MD-02), a pivotal Phase 3 clinical trial evaluating the efficacy, safety and tolerability of ubrogepant, have been published in the November 19th issue of The Journal of the American Medical Association (JAMA). These data reinforced that acute treatment of migraine with ubrogepant compared with placebo led to significantly greater rates of pain freedom at two hours with both the 50 mg and 25 mg doses, and freedom from the most bothersome migraine-associated symptom at two hours with the 50 mg dose. If approved, ubrogepant would potentially be the first FDA-approved small molecule, oral calcitonin gene-related peptide (CGRP) receptor antagonist (gepant) for the acute treatment of migraine.
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"Migraine is the second leading cause of disability, and we need new acute treatments that are efficacious, safe, and tolerable," said Richard B. Lipton, M.D., Lead Author, Professor and Vice Chair of Neurology at the Albert Einstein College of Medicine and Montefiore Health System, Director of the Montefiore Headache Center. "Having ubrogepant as a potential new medication for the acute treatment of migraine will provide much-needed innovation for a disease that causes lost time for millions of people." Dr. Lipton is also a paid consultant for Allergan, the trial sponsor.
The ACHIEVE II trial evaluated ubrogepant 50 mg and 25 mg, compared with placebo, across a wide range of clinical endpoints, including the co-primary endpoints of pain freedom (no pain) and freedom from the most bothersome migraine-associated symptom at two hours post-initial dose. For the two co-primary endpoints, ubrogepant 50 mg and 25 mg showed statistically significant higher response rates for pain freedom at two hours (21.8% for 50 mg, 20.7% for 25 mg and 14.3% for placebo), and the 50 mg dose demonstrated statistically significant higher response rates for the freedom from the most bothersome migraine-associated symptom at two hours (38.9% for 50 mg and 27.4% for placebo). Additionally, ubrogepant 50 mg was statistically superior to placebo in the absence of light sensitivity (43.8% for 50 mg and 35.5% for placebo) and sound sensitivity (54.1% for 50 mg and 46.3% for placebo).
Ubrogepant studies show that both the 50 mg and 25 mg doses were well tolerated with an adverse event profile similar to placebo. The most common adverse reaction during the single attack studies (occurring with an incidence greater than 2 percent and at least twice the rate of placebo) was nausea (incidence 2-4%). In a year-long extension study, the most common treatment-related adverse event was also nausea, with an incidence <2 percent.
"I have been living with migraine attacks for most of my life, but unfortunately, I can't tolerate existing prescription treatments when I start having pain," said Anna Williams, migraine patient. "We really need new treatments, which is why I am so excited to see new research published in a prestigious medical journal about a medication that may provide what patients need."
Triptans are the most popular acute treatment for migraine representing 70 percent of prescriptions. However, for people living with migraine disease, approximately 20 percent of individuals have multiple cardiovascular (CV) risk factors, and because triptans restrict blood vessels, they may not be appropriate for these migraine patients. And for those who take triptans, as many as 30 percent may not sufficiently respond or may experience side effects. In the ACHIEVE II trial, approximately 11 percent of participants had moderate to severe CV risk factors, and 23 percent of participants previously had an insufficient response to triptans.
"If approved, ubrogepant will provide a new and different acute treatment option for patients suffering the debilitating pain and other symptoms of migraine. Allergan has a long history of developing migraine medications and remains committed to continued innovation of new treatments," said Mitchell Mathis, M.D., VP, Chief Medical Officer, Central Nervous System at Allergan. "Ubrogepant is a completely new approach to the acute treatment of migraine. This would expand Allergan's migraine portfolio that includes BOTOX®, the first FDA-approved, preventive treatment for adults with chronic migraine. We are also continuing to advance the Phase 3 clinical program for atogepant, our second orally-administered gepant specifically for migraine prevention. We believe in having multiple treatment options available because we know not every patient will respond to every medication. We believe that patients should have open access to all new treatments for migraine."
The JAMA full article is available at http://bit.ly/32Wyo3s