{
  "abstract": "Background and Importance Rimegepant and atogepant have demonstrated efficacy in the prophylaxis of high-frequency episodic migraine (rimegepant and atogepant) and chronic migraine (atogepant), according to the ADVANCE and PROGRESS clinical trials (CT) for atogepant and BHV3000-301, -302, and -303 CT for rimegepant.Aim and Objectives To assess the efficacy of rimegepant and atogepant in migraine prophylaxis among outpatients at a tertiary-level hospital.Material and Methods A retrospective observational study was conducted from July 2024 to March 2025 including outpatients initiating treatment with gepants. Variables analysed were sex, age, treatment duration, number of prior non-biologic and biologic prophylactic drugs, monthly migraine days (MMD) before treatment, MMD after 9–12 weeks (MMDw9–12), treatment adherence, change in MMD, and the proportion of patients achieving ≥50% MMDw9–12 reduction. Data were obtained from electronic medical records.Results Forty-two patients were included: 18 treated with rimegepant and 24 with atogepant; (88.1% women). Median age was 45 years (IQR:34.7-54). Median treatment duration with rimegepant was 9.4 weeks (IQR:4.4-19.4), 4.4 (IQR:3.8-4.6) in early discontinuations, and 12.9 (IQR:5.5-19.4) in the remainder. For atogepant, median duration was 9.7 weeks (IQR:5.2-14), 6.1 (IQR:5-7.1) in early discontinuations, and 11.4 (IQR:5.4-15.6) otherwise. Median number of prior non-biologic prophylactics was 6.5 (IQR:5-7.5) for rimegepant and 6 (IQR:5-8) for atogepant. Regarding previous biologics, for rimegepant: 55.6% had none, 11.1% one, 16.7% two, 11.1% three, and 5.6% four; for atogepant: 33.3% none, 12.5% one, 20.8% two, 20.8% three, and 12.5% four. Median baseline MMD was 15.5 (IQR:10-30). MMDw9–12 was available for 24 patients (57.1%); data were missing due to early discontinuation in 7 (16.7%) and absent migraine calendars in 10 (23.8%). Median post-treatment MMD was 15 (IQR:6.5-20), with a median adherence of 91.55% (IQR:0.81-0.99). Median MMD change was −2.25 (IQR:(−10.1)-0); −2.5 (IQR:(−5.75)-0) for rimegepant and −2 (IQR:(−12)-0) for atogepant. A ≥50% MMDw9–12 reduction was achieved by 25% overall, 25% with rimegepant, and 23.1% with atogepant.Conclusion and Relevance Despite the small cohort, response variability and modest clinical benefit suggest uncertainty regarding efficacy, with no notable differences between both gepants. The variation in MMD and ≥50% MMD reduction during weeks 9–12 were lower for both drugs than those reported in CT.Conflict of Interest No conflict of interest",
  "authors": [
    {
      "affiliations": [
        "Hospital Juan Ramón Jiménez, Hospital Pharmacy, Huelva, Spain"
      ],
      "name": "I Corriente Gordón"
    },
    {
      "affiliations": [
        "Juan Ramon Jimenez Hospital, Hospital Pharmacy, Huelva, Spain"
      ],
      "name": "E Paradela Garcia"
    },
    {
      "affiliations": [
        "Juan Ramon Jimenez Hospital, Hospital Pharmacy, Huelva, Spain"
      ],
      "name": "A Romero Ruiz"
    },
    {
      "affiliations": [
        "Juan Ramon Jimenez Hospital, Hospital Pharmacy, Huelva, Spain"
      ],
      "name": "E Sánchez Gómez"
    },
    {
      "affiliations": [
        "Juan Ramon Jimenez Hospital, Hospital Pharmacy, Huelva, Spain"
      ],
      "name": "MD Santos Rubio"
    }
  ],
  "title": "4CPS-155 Efficacy of rimegepant and atogepant in migraine prophylaxis",
  "uid": "ee03f044-e883-5a72-897d-c3756c11d151"
}