Reacción a "A drug reduces the symptoms that precede migraine in a phase III trial"

“The study is the first to investigate whether migraine can be effectively interrupted in its prodromal phase"

Current practice:
"Acute medication is primarily used to treat headaches during the actual migraine attack. However, it has long been known that migraines begin much earlier—often with prodromal symptoms such as cognitive impairment, sensitivity to light and noise, and circulatory problems. The study presented here focuses specifically on these early symptoms and the possibility of interrupting migraines at this stage".

Results:
“The authors conclude from the results of their study that the pathophysiological causes of migraine are likely to originate in the central nervous system. They base this assumption on the fact that ubrogepant therapy is effective in the early stages of migraine and influences symptoms that are associated with the central nervous system".

Methodology and significance in terms of efficacy:
“The statistical significance of an exploratory analysis is inherently weaker than that of a controlled study specifically designed to address this question. Nevertheless, the available data provide initial indications that ubrogepant may be effective in the prodromal phase of migraine. This at least supports an interesting hypothesis. However, further, specifically designed studies are needed to scientifically confirm this promising approach.”

Difference between the prodromal phase and the aura phase:
“It is important to distinguish clearly between the prodromal phase, i.e., the early phase of migraine, and the aura phase. The symptoms investigated in this study, such as cognitive impairment, fatigue, and sensitivity to light, occur in the prodromal phase. These are not the aura, which is characterized by other neurological symptoms such as scintillating scotoma (visual disturbances with flickering or flashing lights; editor's note) and must be clearly distinguished from it. The potential efficacy of ubrogepant in the aura phase was not investigated in this study.”Future and additional benefits of ubrogepant".

Future and additional benefits of ubrogepant:Ubrogepant is a new and promising substance for the acute treatment of migraine. Its use in the prodromal phase would be particularly interesting, as this would represent a therapeutic add-on that is not currently available. Since this group of drugs is not thought to be associated with the risk of medication overuse headache, the early use of ubrogepant would be even more appealing. It would be good if the EMA approved it too. I'm not sure if they're planning to do that yet, though".