Abstract Details

Title Comparative Efficacy of Atogepant Formulations for Migraine: A Frequentist and Bayesian Network Meta-analysis

Topic Headache

Presentation(s) P10 - Poster Session 10 (8:00 AM-9:00 AM)

Poster/Presentation
Number 15-013

Objective To compare the efficacy of different Atogepant regimens for migraine prevention using network meta-analysis, focusing on migraine and headache days, acute medication use, and ≥50% response rates.

Background Migraine is disabling, and preventive treatments are limited. Atogepant shows promise, but comparative evidence across doses is lacking.

Design/Methods We searched PubMed, EMBASE, Scopus, and Web of Science through September 2025 for RCTs on Atogepant in migraine prevention. A frequentist network meta-analysis (netmeta, R) using a random-effects model compared dosing regimens across migraine days, headache days, acute medication use, and ≥50% responders, reporting MDs or ORs with 95% CIs and assessing heterogeneity and consistency (τ², I², Q). Language refinement was assisted by ChatGPT (OpenAI, GPT-5)

Results Across six RCTs including 4,325 participants, all Atogepant regimens significantly reduced migraine and headache days versus placebo. For migraine days, MDs were –1.84 (95% CI –2.55 to –1.14) for 30 mg BD, –1.57 (95% CI –2.39 to –0.74) for 60 mg BD, –1.46 (95% CI –1.93 to –0.99) for 60 mg OD, –1.30 (95% CI –1.84 to –0.75) for 30 mg OD, and –1.26 (95% CI –1.84 to –0.68) for 10 mg OD. Corresponding reductions in headache days were –1.75 (95% CI –2.38 to –1.12), –1.67 (95% CI –2.53 to –0.82), –1.62 (95% CI –2.01 to –1.23), –1.52 (95% CI –1.96 to –1.08), and –1.45 (95% CI –1.92 to –0.99). Acute medication use declined (MD ≈ –1.4 to –1.8), and the odds of achieving ≥50% migraine reduction were higher for all regimens (OR 2.36–2.72 vs placebo). P-scores and SUCRA ranked 30 mg BD and 60 mg BD as most efficacious. Heterogeneity was modest (I² = 35%), and findings were robust in sensitivity analyses.

Conclusions All Atogepant regimens effectively reduced migraine and headache days and decreased acute medication use, with 30 mg BD and 60 mg BD showing the greatest benefit.

Authors/Disclosures
Aman Bakhsh, MBBS PRESENTER	Dr. Bakhsh has nothing to disclose.
Rishu Raj, MBBS	Mr. Raj has nothing to disclose.
Arkansh Sharma	Mr. Sharma has nothing to disclose.
Aditi Agarwal, MBBS	Ms. Agarwal has nothing to disclose.
Medhansh Biradar, MBBS	Mr. Biradar has nothing to disclose.

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