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ubrelvy

CGRP Medications: Better for Men, or Women?

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CGRP related medications for migraine are helping a lot of people. But if you’re going to try one, which medication should you start with? Does your sex make a difference?

Gepant drugs - a difference between women and men?

This is a question that is rarely asked or studied. That’s why a study review published in the medical journal Cephalalgia this year caught my attention. It was one of many studies on CGRP-related drugs – but in this case it was looking at the difference between men and women.

And in the case of one type of drugs, there was a difference – the “gepants” – that is, CGRP receptor inhibitors/antagonists. The specific drugs we’re talking about are:

  • ubrogepant (Ubrelvy)
  • rimegepant (Nurtec ODT)
  • zavegepant (Zavzpret)

Now, when these medications are used for acute migraine treatment – that is, when they’re taken to stop a migraine attack in progress – the evidence is positive. For women. However, for men, there is not yet enough evidence to show a clear benefit.

That doesn’t mean they won’t work for you – and maybe future studies will show a clearer benefit. But it could be that some of the CGRP medications simply work better in women.

It would be helpful to have further studies here, because if this difference stands up in further trials, it would be an easy way to pop certain types of medication higher on the list, because they’ll have a better chance of success, for you.

What about other CGRP medications? The meds for chronic migraine known as CGRP antibodies (the ones that end in “umab” – like fremanezumab or erenumab) seemed to work well for both sexes. Preventative CGRP medications also seemed to help both men and women, but the authors of the study would like to keep an eye out for differences in future studies.

Again, at this point this information shouldn’t stop you from trying CGRP medications. It may be information that can be added to the other info your doctor has in order to decide which to try first.

That being said, we look forward to future studies. Anytime we can make the path shorter to something that works to fight your migraine, we’re very interested.

It will also be very helpful in the future to find out why this is, so that we can better target migraine attacks.

To check out the study for yourself, click on Evaluation of outcomes of calcitonin gene-related peptide (CGRP)-targeting therapies for acute and preventive migraine treatment based on patient sex (pdf).

Ubrelvy: Not the Silver Bullet, but Helping Many

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Ubrelvy, generic name ubrogepant, is a migraine drug that was approved in the USA late 2019. We’re just now beginning to see how it’s working for real people in the real world.

Ubrelvy is an abortive medication, taken to stop a specific migraine attack when it hits. And so far, it’s doing as well as expected – actually, maybe better – for patients that have been taking it in everyday life.

Last month, Dr. Chia-Chun Chiang from the Mayo Clinic presented some preliminary findings at the American Headache Society Annual Meeting. Patients were asked to report on their use of ubrogepant 1 month to 3 months after it was prescribed. Here are some of the results from 57 patients:

Satisfied with ubrogepant?

So most patients, 66%, were either somewhat satisfied or very satisfied with ubrogepant.

Next, researchers looked at the goal of being pain-free within two hours. Now, you can take another dose after two hours if needed, but ideally you should have significant relief by then. In total, 27% reported that they had general relief in all their migraine attacks when they took ubrogepant. 73% had relief at least one time when they took it, and 32% were free from headache at two hours during at least one attack.

So, for most people it worked some of the time. But for 27%, it provided consistent relief.

The numbers sound a little more impressive when you realize that most of the patients in this study (81%) had chronic migraine. Now, this shouldn’t be your only treatment if you have chronic migraine, because you shouldn’t be taking it that often. But it says something that it was working for many patients who have a very serious migraine condition, and who have probably tried a number of other medications.

So the bottom line is that, so far, this medication does seem to be helping a lot of people. We’ll look forward to seeing more “real world results” in the months ahead.

via: Study collects real-world data on newly approved migraine treatments

More on Ubrelvy and Related Migraine Medications (video)

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A couple of days ago we looked at the most important information that you need to know about Ubrelvy (ubrogepant), the very first of a new type of migraine drug.

If you have a little more time, you might want to watch this video interview with Dr. Robert Cowan, where he discusses ubrogepant and various other new medications. (Note that this interview was done a few weeks before Ubrelvy was actually approved.)

Ubrelvy – Fast Facts about the New Migraine Drug

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Just over 2 weeks ago, the FDA approved a brand new migraine drug – Ubrelvy – and it really is different than the other drugs that have been approved recently, although there are some similarities.

Ubrelvy - ubrogepant

We’ve been talking about this drug for a long time, under the generic name ubrogepant (previously MK-1602). But now that it’s approved in the USA, here’s the most important information to be aware of.

  • Name: Ubrelvy (ubrogepant)
  • Type: CGRP Receptor Antagonist (not a CGRP inhibitor)
  • Purpose: Abortive drug – for “acute” treatment. Taken during a specific migraine attack.
  • How taken: oral
  • Dosage: 50mg or 100mg. A second dose may be taken after 2 hours if needed (there are some exceptions to this – talk to your doctor and read here). If you have more than 8 migraine attacks in 30 days, you will want to look for other options.
  • Side Effects: During trials, most patients did not experience significant side effects. About 4% experienced nausea, and 3% somnolence (fatigue, drowsiness).
  • Specific Populations: Ubrelvy should not be taken during pregnancy, and risk should be discussed if taken during breastfeeding. Also discuss risk if you have kidney or liver problems. Patients with end-stage renal disease should also avoid Ubrelvy. This drug has not been studied for children.
  • Contraindications: If you are taking a strong CYP3A4 inhibitor, Ubrelvy is not recommended. Please talk to your doctor about all medications and supplements you are taking.

A couple of things to note from the information above. The drugs that were making headlines last year were CGRP inhibitors, which to this point have been preventatives – drugs taken on a regular basis to prevent migraine. They are also injections. So this drug is quite different.

Although CGRP related, it has a different mechanism. Because it seems to work quickly, it is recommended as an abortive – taken during an attack to stop or lessen the symptoms.

So how well does Ubrelvy work? According to this study, about 20% of patients were pain-free within 2 hours, and about 38% had freedom from the worst symptoms.

Remember, Ubrelvy may work for you when other medications have not worked, because it functions in a different way from any other medication.

Most of this information is from the official Ubrevly site, where you can read more details.

Have you tried Ubrely? Please leave a comment with your experiences.

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