New drug for migraine pain may suit more people than existing drugs

Migraine breakthrough as trial proves new drug can relieve sufferers of pain within two hours

  • More than 20% of people given the drug ubrogepant had relief in two hours
  • Ubrogepant targets a protein thought to be involved in the feeling of pain  
  • Current medicines narrow blood vessels which aren’t suitable for everyone 
  • Ubrogepant could make a ‘big difference’ to some patients, scientists said

A new drug may alleviate agony for scores of migraine patients not deemed suitable to take existing medications.  

Ubrogepant relieved migraine pain within two hours for a fifth of patients, according to a trial.

And it alleviated bothersome symptoms, which include light and noise sensitivity, in 34 per cent of sufferers.

Current migraine drugs work by narrowing blood vessels – but these are not deemed safe for people at risk of a heart attack or stroke. 

Ubrogepant could make a ‘big difference’ for those patients, who are desperate for a drug that works for them, the developers said. 

The drug, ubrogepant, relieved migraine pain within two hours for more than a fifth of people given it in a large-scale clinical trial (stock)

The drug blocks a protein in the nervous system involved in pain signalling, blunting any discomfort. 

Roughly 8.5million people in Britain suffer from migraines. Around 38million people suffer in the US, according to figures.

The pain typically affects one side of the head. Other symptoms can include nausea, vomiting, and light, noise and smell sensitivity.  

Ubrogepant, made by the pharmaceutical company Allergan, is pending approval by the US Food and Drug Administration. There are also plans to get it licensed in Europe and Asia.

The trial, led by the Montefiore Headache Center in New York, was published in the medical journal JAMA.

Some of the 1,700 patients were given a placebo. The others received either a 25mg dose of ubrogepant, or a 50mg one.

A fifth of patients in the lower-dose group felt pain-free after two hours. And 34.1 per cent were relived of the most bothersome symptoms.

WHAT HELPS TO PREVENT MIGRAINES?

Being open to new experiences reduces people’s risk of migraines, research suggested in June 2017.

A preference for variation over routine prevents crippling headaches among depression sufferers, a study found.

Yet, neuroticism – a personality trait associated with nervousness and irritability – increases migraine’s risk, the research adds.

Study author Dr Máté Magyar from Semmelweis University in Budapest, said: ‘An open character appears to offer protection from [migraine].

‘Our study results could help to provide a better understanding of the biopsychosocial background of migraine, and help to find novel strategies in the prevention of and interventions for [migraine].’ 

The researchers analysed the relationship between personality traits, depression and migraines in more than 3,000 sufferers of the mental-health condition.

Depression is associated with an increased risk of migraines.

The participants were ranked according to their openness, conscientiousness, extraversion, agreeableness and neuroticism. 

The higher dose was slightly better for discomfort, with 21.8 per cent patients pain-free within 120 minutes. It alleviated other symptoms in 38.9 per of the sufferers.  

In comparison, the success rates for the placebo group were just 14 and 27 per cent, respectively.

But researchers admitted ubrogepant is not as successful at relieving symptoms as triptans – standard treatment for more severe migraine attacks.

Triptans, which constrict blood vessels around the brain to stop pain, have shown response rates ranging from 40 per cent to 75 per cent.   

Because of this, patients at risk of heart disease and stroke are not supposed to take triptans, so doctors must find new medicines to give them. 

Triptans, such as Zomig and Maxalt, also have side effects — including numbness, dizziness and drowsiness — that can make them difficult to take.

This is where ubrogepant offers hope. It belongs to a class of medications called CGRP inhibitors. 

CGRP (calcitonin gene-related peptide) is a protein, released by the trigeminal nerve in the brain, which is involved in the transmission of pain.

Levels of CGRP rise during a migraine attack and are believed to play a key role in generating the pain, lead author Dr Richard Lipton said.  

Three CGRP inhibitors – Aimovig, Ajovy, and Emgality – already exist and are injection drugs that can be used regularly to prevent migraine attacks. 

They have been approved by the FDA for use in the US. In the UK, only Aimovig is available for use in Scotland because the NHS’s spending watchdog for England and Wales have refused to fund it.

Ubrogepant is different because it’s a tablet and is used when a migraine happens, rather than to prevent it. Another oral type of the drug, called rimegepant, is also in the pipeline.  

Dr Lipton said: ‘Migraine is the second leading cause of disability, and we need new acute treatments that are efficacious, safe, and tolerable.

‘Having ubrogepant as a potential medication for the acute treatment of migraine will provide much-needed innovation for a disease that causes lost time for millions of people.’

The exact cause of migraines is unknown, but it may run in families.

They’re thought to be the result of temporary changes in the chemicals, nerves and blood vessels in the brain.

Some people find migraine attacks are caused by triggers such as starting their period, stress, tiredness or certain foods or drinks.  

Some migraines can be treated with over the counter medications, such as ibuprofen, acetaminophen or aspirin, if taken at the first signs of a migraine occurring. 

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