A phase IIb randomized, double-blind, placebo-controlled trial of ubrogepant for the acute treatment of migraine

Tiffini Voss, Richard B. Lipton, David W. Dodick, Nicole Dupre, Joy Yang Ge, Robert Bachman, Christopher Assaid, Sheena K. Aurora, David Michelson

Research output: Contribution to journalArticle

86 Citations (Scopus)

Abstract

Aim The aim of this trial was to evaluate the efficacy and tolerability of ubrogepant (MK-1602), a calcitonin gene-related peptide receptor antagonist (CGRP-RA), for the acute treatment of migraine. Methods This double-blind, placebo-controlled study randomized 834 participants to treat one migraine attack with ubrogepant 1 mg, 10 mg, 25 mg, 50 mg, 100 mg, or placebo in a 1:1 ratio. The co-primary endpoints were pain freedom and headache response at two hours. The first primary hypothesis tested the dose-response trend for two-hour pain freedom using a logistic regression model. Subsequent hypotheses tested the effects of each dose on the co-primary endpoints, using a closed sequential testing procedure to control for multiplicity. Results A total of 527 participants received ubrogepant and 113 received placebo. A positive response trend in the proportion of participants achieving two-hour pain freedom was demonstrated (p <0.001). Ubrogepant 100 mg was significantly superior to placebo for two-hour pain freedom (25.5% vs 8.9%) but not for two-hour headache response. Per the prespecified multiplicity strategy, this nonsignificant result precluded further formal hypothesis testing, although the 50 mg and 25 mg doses demonstrated nominal significance over placebo for two-hour pain freedom (unadjusted p <0.05). Overall, adverse events were similar between ubrogepant and placebo. Conclusion This trial supports ubrogepant's efficacy and provides further evidence that CGRP-RAs are viable options for the acute treatment of migraine.

Original languageEnglish (US)
Pages (from-to)887-898
Number of pages12
JournalCephalalgia
Volume36
Issue number9
DOIs
StatePublished - Aug 1 2016

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Migraine Disorders
Placebos
Pain
Headache
Therapeutics
Logistic Models
Calcitonin Gene-Related Peptide Receptors
Double-Blind Method

Keywords

  • calcitonin gene-related peptide receptor antagonist
  • CGRP
  • migraine
  • MK-1602
  • ubrogepant

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

A phase IIb randomized, double-blind, placebo-controlled trial of ubrogepant for the acute treatment of migraine. / Voss, Tiffini; Lipton, Richard B.; Dodick, David W.; Dupre, Nicole; Ge, Joy Yang; Bachman, Robert; Assaid, Christopher; Aurora, Sheena K.; Michelson, David.

In: Cephalalgia, Vol. 36, No. 9, 01.08.2016, p. 887-898.

Research output: Contribution to journalArticle

Voss, T, Lipton, RB, Dodick, DW, Dupre, N, Ge, JY, Bachman, R, Assaid, C, Aurora, SK & Michelson, D 2016, 'A phase IIb randomized, double-blind, placebo-controlled trial of ubrogepant for the acute treatment of migraine', Cephalalgia, vol. 36, no. 9, pp. 887-898. https://doi.org/10.1177/0333102416653233
Voss, Tiffini ; Lipton, Richard B. ; Dodick, David W. ; Dupre, Nicole ; Ge, Joy Yang ; Bachman, Robert ; Assaid, Christopher ; Aurora, Sheena K. ; Michelson, David. / A phase IIb randomized, double-blind, placebo-controlled trial of ubrogepant for the acute treatment of migraine. In: Cephalalgia. 2016 ; Vol. 36, No. 9. pp. 887-898.
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