
The ACHIEVE II study included 1,686 U.S. adult patients randomized (1:1:1) to placebo, ubrogepant 25 mg and 50 mg respectively, to treat a single migraine attack of moderate-to-severe headache intensity.
In the modified ITT (mITT) population of 1355 patients, both doses showed a statistically significant greater percentage of ubrogepant patients achieving pain freedom at 2 hours after the initial dose as compared to placebo patients (25 mg vs placebo, p=0.0285, 50 mg vs placebo, p=0.0129) and the 50 mg dose demonstrated a statistically significant greater percentage of ubrogepant patients achieving absence of the most bothersome migraine-associated symptom at 2 hours after the initial dose as compared to placebo patients (50 mg vs placebo, p=0.0129). The 25 mg dose demonstrated improvement in the percentage of ubrogepant patients achieving absence of the most bothersome migraine-associated symptom at 2 hours after the initial dose as compared to placebo patients, however failed to demonstrate statistical significance (25 mg vs placebo, p=0.0711). (See Table)
Table: Co-Primary Endpoint Results For Each Ubrogepant Dose vs Placebo (mITT population) Endpoints Statistics Placebo
(N=456) Ubro 25mg
(N=435) Ubro 50mg
(N=464) Co-Primary Endpoint 1: Pain Free at 2 14.3 20.7 21.8 Adjusted - 0.0285 0.0129 Co-Primary Endpoint 2: Absence of 27.4 34.1 38.9 Adjusted - 0.0711 0.0129 1 Most Bothersome Symptoms including Photophobia, Phonophobia or Nausea.
Pain Freedom 2 Hours After
Initial Dose
Hours, %
p-value
Absence of Most Bothersome
Symptom1 2 Hours After Initial
Dose
MBS1, %
p-value
The 50 mg dose of ubrogepant also showed a statistically significant greater percentage of patients achieving pain relief at 2 hours, sustained pain relief from 2-24 hours, and sustained pain freedom from 2-24 hours after the initial dose as compared to placebo (50 mg vs placebo, p=0.0129 for each of these endpoints). In addition, ubrogepant 50 mg also showed a statistically significant greater percentage of patients achieving absence of photophobia (p= 0.0167) and phonophobia (p= 0.0440) at 2 hours after the initial dose as compared to placebo. Ubrogepant 25 mg compared to placebo failed to demonstrate statistical significance in these endpoints.
"We are pleased to share these positive results from ACHIEVE II, our second Phase 3 study supporting the efficacy, safety, and tolerability of 50 mg ubrogepant. The consistency in response between both ACHIEVE I and ACHIEVE II provides further evidence that ubrogepant, an oral calcitonin gene-related peptide (CGRP) receptor antagonist, offers a promising opportunity for the acute treatment of migraine", said
In ACHIEVE II, ubrogepant was well tolerated and demonstrated a safety profile similar to placebo. There was no signal of hepatotoxicity for ubrogepant. The most common adverse events were nausea and dizziness, neither of which was reported with a frequency >2.5%. In terms of hepatic safety within 30 days of dosing, there were 4 cases (1 in placebo and 3 in ubrogepant arms) with aminotransferase (ALT or AST) elevations greater than 3 times (but not higher than 5 times) the upper limit of normal (ULN). Each of these 4 cases were adjudicated by a blinded panel of liver experts and none were noted by the liver safety adjudication board to have a probable relationship to ubrogepant. Of these 4 cases, one case was noted within 7 days of drug administration (attributed to exercise-induced rhabdomyolysis, on 50 mg ubrogepant and again, noted by the liver safety adjudication board to not have a probable relationship to ubrogepant). There were no cases of Hy's Law.
"Given the prevalence of migraine and significant disability that many patients face, ubrogepant may provide a new option for those having tolerability issues with current migraine-specific treatments." said Dr.
Additional results from this study are anticipated to be released at upcoming scientific meetings throughout 2018.
About ACHIEVE II Study
The ACHIEVE II trial is a Phase 3, multicenter, randomized, double-blind, placebo-controlled, parallel-group study to evaluate the efficacy, safety, and tolerability of 2 doses of ubrogepant (25 mg and 50 mg) compared to placebo for the treatment of a single migraine attack. The modified ITT population included 1355 adult patients 18-75 years of age with a history of migraine (with or without aura) randomized (1:1:1) to placebo, ubrogepant 25 mg, or ubrogepant 50 mg to treat a single migraine attack of moderate or severe headache pain intensity at home. The co-primary efficacy parameters were pain freedom (PF) at 2 hours after the initial dose (defined as a reduction in headache severity from moderate/severe at baseline to no pain at 2 hours after the initial dose) and absence of the most bothersome migraine-associated symptom (photophobia, phonophobia or nausea) at 2 hours after the initial dose.
About Ubrogepant
Ubrogepant is a novel, highly potent, orally-administered CGRP receptor antagonist in development for the acute treatment of migraine. CGRP and its receptors are expressed in regions of the nervous system associated with migraine pathophysiology. CGRP receptor antagonism is a novel mechanism of action for the acute treatment of migraine that clearly differs from the mechanisms of currently available triptans (serotonin 1B/1D agonists) and opioids.
Conference Call and Webcast
A taped replay of the conference call will also be available beginning approximately two hours after the call's conclusion, and will remain available through 11:30 p.m. Eastern Time on May 27, 2018. The replay may be accessed by dialing (855) 859-2056 or (404) 537-3406, and entering the conference ID 6399589.
To access the webcast, please visit
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. The current standards of care in the acute treatment of migraine are not optimal for many patients due to partial effectiveness, poor tolerability, or contraindications. As a consequence, patients may experience repeated, uncontrolled attacks leading to medication overuse and increased risk of migraine disease progression. There is a need for new treatments for migraine with improved benefit-risk profiles as compared to current standard of care.
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