A Case of Acute Migraine Without Aura Treated With a New FDA-Approved Medication Ubrogepant

TL;DR

A new FDA-approved drug called ubrogepant significantly reduced migraine severity and disability in a patient who had not responded to other treatments.

Contribution

This case report demonstrates ubrogepant's efficacy in reducing migraine duration by more than 50%, a novel finding not previously documented.

Findings

Ubrogepant reduced headache duration from 36-60 hours to less than 12 hours.

The patient's headache severity decreased from 7.5/10 to 3/10 after treatment.

Migraine-related disability and quality of life improved significantly.

Abstract

Ubrogepant is the first medication that blocks calcitonin gene-related peptide (CGRP), a protein released during a migraine attack, from binding to its receptors. Ubrogepant has shown positive safety, efficacy, and tolerability results for the treatment of acute migraine in phase 3 randomized trials. At this time, there are very few case reports on ubrogepant. Herein, we describe a complex patient with treatment-resistant migraine who showed substantial improvement in migraine severity, duration, and overall disability after using ubrogepant.

A 46-year-old woman with a 25-year history of migraine presented with an improvement in headache severity, duration, and disability after using a new FDA-approved medication, ubrogepant, for less than five months. Before commencing ubrogepant,her headache duration hours ranged from 36 to 60 hours, headache severity was rated 7.5/10, and mean headache days ranged from 10 to 12 days. After taking ubrogepant, her headache duration was less than 12 hours, headache severity was 3/10, and mean headache days was five.

Previously, she had been prescribed a combination of first-line medications with little improvement in headache severity. Her Migraine Disability Assessment (MIDAS) score showed moderate disability resulting in missed work and lower quality of life. To date, there have been no case reports showing the efficacy of the new FDA-approved medication, ubrogepant, showing a greater than 50% decrease in headache duration.

Figures