Irish pharmaceutical company Allergan’s ubrogepant is currently in pre-registration for the treatment of acute migraines. It’s an oral pill belonging to a novel class of medications known as calcitonin gene-related peptide (CGRP) inhibitors.
A large-scale clinical study of 1,700 patients showed ubrogepant to be effective at easing pain and light or sound sensitivity as well as providing nausea relief.
Although ubrogepant is expected to receive FDA approval before the end of this year, clinical studies demonstrated that 39% of ubrogepant users got relief from symptoms within two hours.
Ubrogepant, if approved, will experience competition from Eli Lilly’s Reyvow (lasmiditan) on the market because both drugs offer a new mechanism of action for treating acute migraines. Despite this, GlobalData forecasts that ubrogepant will generate global sales of $486m by 2025.
CGRP is localised to neurons in the trigeminal ganglia and CGRP levels are increased during a migraine attack, presumably causing the vasodilation observed. The mechanism of action of CGRP antagonists is inhibition of neurogenic vasodilatation and inflammation by antagonizing the effects of CGRP. Accordingly, it is conceivable that inhibition of CGRP-evoked dilatation of the cranial vessels provides an effective treatment for migraine headache.
Ubrogepant has the potential to be a more appealing option than established drugs like triptans, which people often do not respond to or experience blood vessel constriction. Unlike the triptans, ubrogepant does not constrict blood vessels, which means people at risk of heart attacks or stroke can use it.
Allergan is looking to target other patient groups; its pipeline drug atogepant, which is also an oral CGRP antagonist, is in development for the prevention of an episodic and chronic migraine.