Poster Number-30 - Real-World Effectiveness of Ubrogepant for the Acute Treatment of Migraine in Combination With OnabotulinumtoxinA Preventive: Results From the COURAGE Study

Using data collected via the Migraine Buddy application, this prospective, observational study evaluated real-world acute treatment effectiveness in people taking preventive treatment and ubrogepant 50 mg or 100 mg for acute treatment of migraine. Eligible participants were adults who reported ≥3 migraine attacks in the last 30 days, had treated ≥3 prior attacks with ubrogepant, and were concurrently taking an anti-CGRP monoclonal antibody (mAb), onabotulinumtoxinA, or both as migraine preventive treatment. Self-reported assessments were collected daily for approximately 30 days. Daily assessments included meaningful pain relief (MPR), defined as a reduction of headache pain to a meaningful degree or remaining pain free if no pain was reported at ubrogepant dosing, and return to normal function (RNF) after dosing. This analysis reports results from the first ubrogepant-treated attack and first 10 ubrogepant-treated attacks in the ubrogepant plus onabotulinumtoxinA group. The repeated attack endpoints were modeled via logistic generalized estimating equations to account for the correlated nature of the repeated attacks.

Results:

A total of 122 participants reported using ubrogepant as acute treatment in combination with onabotulinumtoxinA (without an anti-CGRP mAb) as migraine preventive treatment. A median of 9 attacks (IQR, 6–12) per respondent were recorded. The mean age of participants was 40.4 years, and the majority of participants were female (95.9%) and White (92.2%); 86.9% of respondents had severe or very severe disability as measured by the Migraine Disability Assessment (MIDAS), 84.2% were triptan insufficient responders, 55.7% used ubrogepant 100 mg, and most participants (82.5%) took a single dose of ubrogepant to treat an attack. For the first ubrogepant-treated attack at 2 and 4 hours post-dose, MPR was achieved in 53.3% and 76.2% of participants, respectively. RNF was achieved by 25.4% and 45.9% of ubrogepant-treated participants at 2 and 4 hours post-dose, respectively. For the first 10 ubrogepant-treated attacks, MPR was achieved in 44.8% and 72.9% of attacks at 2 and 4 hours post-dose, respectively. RNF was achieved by 30.1% and 52.1% at 2 and 4 hours post-dose, respectively, for the first 10 ubrogepant-treated attacks.

Conclusion:

These findings support the real-world effectiveness of ubrogepant as an acute treatment in combination with onabotulinumtoxinA, providing evidence for a common treatment pattern. These results also demonstrate the feasibility of using a novel, app-based design to evaluate the real-world effectiveness of migraine treatment. Evaluating the real-world effectiveness of ubrogepant in combination with other preventive treatments is an area of future research consideration.

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