
In study CGP-MD-01 834 U.S. adult patients were randomized (2:1:2:1:2:1) to placebo, 10-mg QD, 30-mg QD, 30-mg BID, 60-mg QD, and 60-mg BID respectively, and treated under double blind conditions 12 weeks for the prevention of episodic migraine. Efficacy analyses were based on the modified ITT (mITT) population of 795 patients. The primary efficacy endpoint was the change from baseline in mean monthly migraine/probable migraine (MPM) headache days across the 12-week treatment period.
All active treatment groups demonstrated a statistically significant reduction from baseline in the primary efficacy parameter (10 mg QD vs placebo, p=0.0236; 30 mg QD vs placebo, p=0.0390; 60 mg QD vs placebo, p=0.0390; 30 mg BID vs placebo; p=0.0034, 60 mg BID vs placebo, p=0.0031). The reported p-values are adjusted for multiple comparisons by controlling the overall type I error rate of the study at 5%, 2-sided.
Primary endpoint: change from baseline in mean monthly migraine/probable migraine (MPM) headache days across 12-week treatment period – mITT population
|
Statistic |
Placebo |
Atogepant |
Atogepant |
Atogepant |
Atogepant |
Atogepant |
|
Baseline |
||||||
|
Mean (Days) |
7.81 |
7.63 |
7.64 |
7.74 |
7.38 |
7.62 |
|
Change from Baseline |
||||||
|
LS Mean (SE) |
-2.85 (0.23) |
-4.00 (0.32) |
-3.76 (0.23) |
-3.55 (0.23) |
-4.23 (0.35) |
-4.14 (0.33) |
|
Atogepant vs Placebo |
||||||
|
Least Squares Mean Difference (SE) |
-1.15 (0.40) |
-0.91 (0.33) |
-0.70 (0.33) |
-1.39 (0.42) |
-1.29 (0.41) |
|
|
Adjusted p-value |
0.0236 |
0.0390 |
0.0390 |
0.0034 |
0.0031 |
|
Additional details and results from other endpoints are anticipated to be presented at upcoming scientific meetings.
"We are extremely pleased to share these positive results for atogepant -- our first phase 2b/3 study in Episodic Migraine—which represent a tremendous opportunity in the prevention of migraine, with a convenient, oral dosage form that is currently unavailable," said
In the CGP-MD-01 trial, atogepant was well tolerated. The most common adverse events were nausea, fatigue, constipation, nasopharyngitis, and urinary tract infection which were reported with a frequency >5% in at least 1 atogepant treatment arm and greater than placebo. There was no signal of hepatotoxicity with atogepant in this study with daily administration over 12 weeks. The liver safety profile for atogepant was similar when compared to placebo.
Atogepant CGP-MD-01 Liver Safety Profile
|
Parameter |
Placebo |
Atogepant |
Atogepant |
Atogepant |
Atogepant |
Atogepant |
|
|
ALT or AST (U/L) |
|||||||
|
> 3 x ULN |
3/179 (1.7 %) |
2/92 (2.2%) |
1/180 (0.6%) |
3/181 (1.7%) |
1/84 (1.2%) |
1/88 (1.1%) |
|
|
> 5 x ULN |
3/179 (1.7%) |
0 |
0 |
1/181 (0.6%) |
0 |
0 |
|
|
> 10 x ULN |
0 |
0 |
0 |
0 |
0 |
0 |
|
|
> 20 x ULN |
0 |
0 |
0 |
0 |
0 |
0 |
|
|
Potential Hy's Law (ALT or AST > 3XULN and Bilirubin Total >2XULN and |
0 |
0 |
0 |
0 |
0 |
0 |
|
"The positive results from this study show that oral atogepant has a compelling profile relative to other treatment options on the market and in development for the prevention of migraine. We are excited about the prospects for this product and rapidly moving to the next stage of development," said
"These exciting results demonstrate the potential for atogepant for a broad spectrum of migraine patients. The efficacy and safety across doses and dose regimens show promise in a patient population with high unmet treatment needs," said Dr.
About the CGP-MD-01 study
Study CGP-MD-01 is a Phase 2b/3, multicenter, randomized, double-blind, placebo-controlled, parallel-group study conducted in
The study includes a 4-week screening/baseline period prior to randomization, a 12-week double-blind treatment period, and a 4-week safety follow-up period.
To be eligible for study participation, patients must be 18 to 75 years of age (inclusive), have a history of migraine with or without aura for at least 1 year, and experience between 4 to 14 migraine/probable migraine headache days per month on average in the 3 months prior to Visit 1 and in the 28-day baseline period.
Of the 834 randomized patients, the mean age was 40.1 years. Patients were mostly female (86.5%), white (76.1%) or black/African American (20.4%) with a mean Body Mass Index (BMI) of 30.11. Patients enrolled had a history of migraine for an average of 19.37 years with 50.4% of patients diagnosed with Migraine Without Aura and 49.4% of patients diagnosed either with Migraine with Aura or both Migraine With/Without Aura. A total of 82% of patients completed the study. The rate of discontinuation was similar across all treatment groups.
About Atogepant
Atogepant is a novel, highly potent, orally-administered CGRP receptor antagonist in development for the prevention of migraine. CGRP and its receptors are expressed in regions of the nervous system associated with migraine pathophysiology. It is chemically distinct from ubrogepant, our orally-administered CGRP receptor antagonist for the acute treatment of migraine, with a higher potency and longer half-life, making it suitable for preventive treatment.
Oral CGRP receptor antagonism offers a novel, and validated mechanism of action in a patient friendly dosage form for the prevention of migraine.
About Migraine
Migraine is a chronic disease with episodic attacks defined by neurological symptoms such as headache pain, sensitivity to light, sound, and nausea that are often incapacitating. It is highly prevalent, affecting approximately 1 in 7 individuals, and is associated with significant disability leading to societal and economic burden. Despite its prevalence and the availability of treatments, migraine is an underdiagnosed and undertreated disease, and there remains a need for novel oral preventive treatments with improved benefit-risk profiles. Current oral preventive treatments are often ineffective or poorly tolerated. As a result, a substantial number of patients discontinue or cycle through treatments without adequately reducing migraine frequency or severity. This leads to increased disability, preventing those with migraine from performing daily activities and significantly impacting their quality of life. There is a need for new treatments for migraine with improved benefit-risk profiles as compared to current standard of care.
About
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