Up to 170,000 people in England could benefit from a new oral treatment for preventing both chronic and episodic migraines, which could soon be available on the NHS. Atogepant has been recommended for those who have not responded well to other medications or cannot have injections. The National Institute for Health and Care Excellence (NICE) has recommended the drug, which comes in tablet form, after clinical trials suggested it was effective in some adults. It is designed to be taken daily to prevent both chronic migraines, occurring more than 15 times a month, and episodic migraines, occurring between four and 15 times a month.
In its final draft guidance, NICE said atogepant should be offered to people who had unsuccessfully tried three other medications taken by injection or infusion. At first, it will only be available from specialist doctors in secondary care settings, rather than from GPs. Migraines are characterized by a throbbing pain on one side of the head and can last several days. Other symptoms include dizziness, sensitivity to light, and difficulty speaking. It is not clear how many people are affected by migraines, but the NHS believes the number to be about six million across the UK, with many more women experiencing them than men.
This new treatment offers hope to those suffering from debilitating migraines that have not responded to other treatments. According to Rob Music, chief executive of the Migraine Trust, many people with migraines struggled to access similar new drugs because of a lack of knowledge among doctors and long waiting lists for specialists. The charity warns that access to similar treatments must be swift so that migraine patients can benefit from them as quickly as possible. Atogepant works by blocking the receptor of the CGRP protein, which is found in nerves in the head and neck and is thought to cause inflammation and migraine pain. These drugs have fewer side effects than older migraine drugs, some of which were originally developed for other conditions.
Deborah Sloan, who had suffered from chronic migraines for 40 years, said that taking rimegepant had put her life “back on track.” Other treatments led to severe side effects, but rimegepant allowed her to work again after losing two careers because of being unwell with migraines for 20 days of each month. She had to obtain rimegepant privately at first because of the long wait for a referral to a specialist doctor who could prescribe it. Atogepant is expected to be made available on the NHS in England from next month, although it is already available in Scotland to prevent and relieve migraine symptoms
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