Episodic migraine with prior treatment failure: post hoc analysis of the ELEVATE trial

<h3></h3> This was a post hoc analysis of ELEVATE (NCT04740827), a phase 3, randomized, double- blind, placebo-controlled trial of atogepant 60 mg once daily for the preventive treatment of episodic migraine among participants who had previously experienced an inadequate response with 2–4 classes of conventional oral preventive treatment. This analysis was conducted to evaluate the proportions of (1) participants who sustained their initial ≥50%, ≥75%, and 100% reduction in monthly migraine days (MMD) in response to atogepant over 12 weeks of treatment and (2) participants who did not experience an initial response but achieved a subsequent response with continued treatment. Of 315 participants randomized to double-blind treatment, 309 were included in the OTHE population (placebo, n=155; atogepant, n=154). Among atogepant-treated participants, 61.3% (49/80), 52.3% (23/44), and 47.6% (10/21) of participants who experienced a ≥50%, ≥75%, or 100% initial MMD response, respectively, sustained this response throughout the trial. Among participants who did not experience a ≥50% initial response, 48.4% (31/64), achieved this response in month 2 or 3. Only 22.3% (33/148) did not experience a ≥50% reduction throughout the trial. Atogepant 60 mg once daily was well tolerated, and the safety results were consistent with the known safety profile of atogepant.