{"title":"阿佐格坦在偏头痛预防中的作用:系统回顾和荟萃分析。","authors":"Naresh Kumar Ladhwani, Priya Bai, Rohan Lal, Aresha Masood Shah, Sheela Bai, Ghazi Uddin Ahmed, Rimsha Zameer, Varisha Fatima Shaikh, Arsalan Hyder, Sikander Ali, Muhammad Hamza Beg, Maheen Adeeb, Mahir Tesfaye","doi":"10.1186/s12883-025-04394-z","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Atogepant is a CGRP receptor antagonist used in prevention of migraine. This study assesses the safety and efficacy of this drug in management of migraine headaches.</p><p><strong>Methods: </strong>PubMed, Scopus, Web of Science, and Cochrane CENTRAL were searched until March 24, 2025. Outcomes assessed included monthly migraine and headache day change from baseline at 12 weeks, ≥ 50% reduction in monthly migraine days (MMD), acute medication use days at 12 weeks, treatment-emergent adverse events (TEAE), score on Role Function-Restrictive domain of MSQ at 12 weeks, score on daily activity performance and physical impairment domains of AIM-D at 12 weeks. Subgroup analysis was performed based on different doses of atogepant.</p><p><strong>Results: </strong>Six RCTs comprising of 4052 patients were included. Atogepant showed significant improvement in patients with migraine in terms of MMD over 12 weeks at all doses, 10 mg, 30 mg, and 60 mg. Moreover, it also reduced monthly headache days, had 50% reduction in MMD, and reduced days requiring acute medication use. Atogepant was shown to increase the risk of TEAE, particularly gastrointestinal (GI) side effect including constipation and nausea, however, occurrence of other side effects with atogepant use was insignificant.</p><p><strong>Conclusion: </strong>Atogepant is a highly effective CGRP antagonist for migraine prevention, however, it is associated with increased incidence of GI side effects. Further studies are needed to comprehensively investigate the relationship between atogepant dosage and migraine improvement and safety profile.</p>","PeriodicalId":9170,"journal":{"name":"BMC Neurology","volume":"25 1","pages":"375"},"PeriodicalIF":2.2000,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12406345/pdf/","citationCount":"0","resultStr":"{\"title\":\"The role of Atogepant in migraine prevention: a systematic review and meta-analysis.\",\"authors\":\"Naresh Kumar Ladhwani, Priya Bai, Rohan Lal, Aresha Masood Shah, Sheela Bai, Ghazi Uddin Ahmed, Rimsha Zameer, Varisha Fatima Shaikh, Arsalan Hyder, Sikander Ali, Muhammad Hamza Beg, Maheen Adeeb, Mahir Tesfaye\",\"doi\":\"10.1186/s12883-025-04394-z\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Atogepant is a CGRP receptor antagonist used in prevention of migraine. This study assesses the safety and efficacy of this drug in management of migraine headaches.</p><p><strong>Methods: </strong>PubMed, Scopus, Web of Science, and Cochrane CENTRAL were searched until March 24, 2025. Outcomes assessed included monthly migraine and headache day change from baseline at 12 weeks, ≥ 50% reduction in monthly migraine days (MMD), acute medication use days at 12 weeks, treatment-emergent adverse events (TEAE), score on Role Function-Restrictive domain of MSQ at 12 weeks, score on daily activity performance and physical impairment domains of AIM-D at 12 weeks. Subgroup analysis was performed based on different doses of atogepant.</p><p><strong>Results: </strong>Six RCTs comprising of 4052 patients were included. Atogepant showed significant improvement in patients with migraine in terms of MMD over 12 weeks at all doses, 10 mg, 30 mg, and 60 mg. Moreover, it also reduced monthly headache days, had 50% reduction in MMD, and reduced days requiring acute medication use. Atogepant was shown to increase the risk of TEAE, particularly gastrointestinal (GI) side effect including constipation and nausea, however, occurrence of other side effects with atogepant use was insignificant.</p><p><strong>Conclusion: </strong>Atogepant is a highly effective CGRP antagonist for migraine prevention, however, it is associated with increased incidence of GI side effects. 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引用次数: 0
摘要
背景:atgeagent是一种用于预防偏头痛的CGRP受体拮抗剂。本研究评估了该药治疗偏头痛的安全性和有效性。方法:PubMed, Scopus, Web of Science, Cochrane CENTRAL检索至2025年3月24日。评估的结果包括12周时每月偏头痛和头痛日与基线的变化,每月偏头痛日(MMD)减少≥50%,12周时急性用药天数,治疗突发不良事件(TEAE), 12周时MSQ的角色功能限制域评分,12周时AIM-D的日常活动表现和身体损害域评分。亚组分析基于不同剂量的促凝剂。结果:纳入6项随机对照试验,共4052例患者。在所有剂量(10mg、30mg和60mg)下,阿托格坦在偏头痛患者中显示出12周内烟雾病的显著改善。此外,它还减少了每月头痛天数,减少了50%的烟雾病,减少了需要急性用药的天数。同聚剂被证明会增加TEAE的风险,特别是胃肠道(GI)副作用,包括便秘和恶心,然而,使用同聚剂的其他副作用的发生微不足道。结论:Atogepant是一种非常有效的预防偏头痛的CGRP拮抗剂,然而,它与胃肠道副作用的发生率增加有关。需要进一步的研究来全面研究促凝剂剂量与偏头痛改善和安全性之间的关系。
The role of Atogepant in migraine prevention: a systematic review and meta-analysis.
Background: Atogepant is a CGRP receptor antagonist used in prevention of migraine. This study assesses the safety and efficacy of this drug in management of migraine headaches.
Methods: PubMed, Scopus, Web of Science, and Cochrane CENTRAL were searched until March 24, 2025. Outcomes assessed included monthly migraine and headache day change from baseline at 12 weeks, ≥ 50% reduction in monthly migraine days (MMD), acute medication use days at 12 weeks, treatment-emergent adverse events (TEAE), score on Role Function-Restrictive domain of MSQ at 12 weeks, score on daily activity performance and physical impairment domains of AIM-D at 12 weeks. Subgroup analysis was performed based on different doses of atogepant.
Results: Six RCTs comprising of 4052 patients were included. Atogepant showed significant improvement in patients with migraine in terms of MMD over 12 weeks at all doses, 10 mg, 30 mg, and 60 mg. Moreover, it also reduced monthly headache days, had 50% reduction in MMD, and reduced days requiring acute medication use. Atogepant was shown to increase the risk of TEAE, particularly gastrointestinal (GI) side effect including constipation and nausea, however, occurrence of other side effects with atogepant use was insignificant.
Conclusion: Atogepant is a highly effective CGRP antagonist for migraine prevention, however, it is associated with increased incidence of GI side effects. Further studies are needed to comprehensively investigate the relationship between atogepant dosage and migraine improvement and safety profile.
期刊介绍:
BMC Neurology is an open access, peer-reviewed journal that considers articles on all aspects of the prevention, diagnosis and management of neurological disorders, as well as related molecular genetics, pathophysiology, and epidemiology.