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NICE recommends first oral treatment for chronic and episodic migraines

A new oral treatment option for preventing both chronic and episodic migraines has been recommended by NICE in draft guidance.

A new oral treatment option for preventing both chronic and episodic migraines has been recommended by NICE in draft guidance.

Atogepant (Aquipta, made by AbbVie) has been recommended as an option for preventing chronic and episodic migraines in adults who have had at least 4 migraine days per month and where at least 3 previous preventive treatments have failed. This means that up to 170,000 people could now choose it on the NHS in England.

It can be taken as a tablet and works by blocking the calcitonin gene-related peptide (CGRP) receptor in the body. CGRP is a protein found in the sensory nerves of the head and neck and causes blood vessels to dilate, which can lead to inflammation and migraine pain.

Impact of migraines on quality of life

Migraine is a severe and painful long-term health condition affecting over 4.5 million people in England. Common symptoms of an attack can include:

  • head pain,
  • problems with your sight such as seeing flashing lights,
  • being very sensitive to light, sounds and smells,
  • fatigue,
  • feeling sick and being sick.

Chronic migraine is where a person has at least 15 headache days a month, with at least 8 of those having features of migraine. Whereas, episodic migraine is where a person has fewer than 15 headache days each month.

According to the Migraine Trust, it is estimated that 190,000 migraine attacks occur every day in the UK. Over three quarters of people who get migraine have at least one attack each month. These can last between four
hours and three days. It can also have a significant impact on people’s relationship with their
partner or spouse and it can also significantly affect people’s mental health.

Helen Knight, director of medicines evaluation at NICE, said: “Currently, the most effective options for people with chronic migraines who have already tried 3 preventative treatments are drugs that need to be injected. The committee heard from patient experts that some people cannot have injectable treatments, for example because they have an allergy or phobia of needles. So, some people with chronic migraines would welcome an oral treatment. Atogepant also offers more choice for people with episodic migraine.”

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