PO-80 | Real-world effectiveness of atogepant for the preventive treatment of migraine in a cohort of multi -refractory patients: a single center study

M. De Luca,¹ L. Ferraù,¹ A. Cafarchio,² M.S. Adragna,¹ M. Autunno¹ | ¹Unit of Neurology and Neuromuscular Diseases, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy; ²Department of Medicine and Health Sciences “Vincenzo Tibero” DIMES, University of Molise, Campobasso, Italy

Background: Migraine is a leading cause of disability. Atogepant, an oral CGRP receptor antagonist, represents a novel option for preventive migraine treatment, yet real-world data remain limited. With our study we aimed to assess the effectiveness and tolerability of Atogepant in a real-world cohort of patients with high-frequency episodic and chronic migraine refractory to multiple preventive therapies.

Methods: We conducted a single-center, prospective observational study. Fourteen adults with chronic migraine who had failed at least three first-line and one second-line preventive therapies were treated with Atogepant 60 mg daily for a minimum of three months.

Results: A significant reduction in monthly migraine days was observed from baseline (median: 15.0) to month 6 (median: 7.0; p < 0.05). Statistically significant improvements were also detected in MIDAS and HIT-6 scores. Mild adverse events occurred in 10 patients; 3 discontinued treatment due to moderate events. No severe adverse reactions were reported.

Conclusion: In this real-world setting, Atogepant demonstrated good effectiveness and tolerability in patients with treatment-resistant high-frequency episodic and chronic migraine. These findings support its clinical utility as an oral preventive option, particularly for patients already treated with other prophylactic therapies for migraine, including anti-CGRP monoclonal antibodies, and who have shown an insufficient response. Larger studies are needed to confirm long-term efficacy and safety.