Response rates with oral atogepant in participants with prior preventive treatment failure: results from ELEVATE

<h3>Introduction</h3> Atogepant is an oral calcitonin gene-related peptide receptor antagonist. The objective of this analysis was to evaluate monthly migraine day (MMD) responder rates to characterize the efficacy profile of atogepant. <h3>Methods</h3> ELEVATE was a randomized, double-blind, placebo-controlled trial conducted in Europe and North America. Adults with 4-14 MMDs in the previous 3 months and during baseline who had previously failed 2-4 classes of oral medications for preventive treatment of migraine were randomized to atogepant 60 mg once daily (QD) or placebo. This analysis evaluated the proportions of participants achieving ≥25%, ≥30%, ≥50%, ≥75%, and 100% reductions in mean MMDs across 12 weeks and at 4-week intervals. <h3>Results</h3> 309 participants were included. Across the 12-week treatment period, a ≥50% improvement was achieved by 50.6% of atogepant-treated participants vs 18.1% of placebo-treated participants (<i>P</i>&lt;0.0001Treatment effects were observed for the achievement of a ≥25%, ≥30%, ≥75%, and 100% reduction in MMDs across the 12- week treatment period. Treatment effects were observed as early as the first 4-week interval and maintained throughout the double-blind treatment period. No new safety concerns were identified. <h3>Conclusion</h3> Treatment with atogepant 60 mg QD significantly increased participants achieving ≥25%, ≥30%, ≥50%, ≥75%, and 100% reductions in MMDs vs placebo.