Chia-Chun Chiang, MD

“Clinical trial limitations exist in every trial. The results of the clinical trials might not be applied to every individual and the study duration might not be long enough to conclude the long-term safety and tolerability of the new medication.”

Chia-Chun Chiang, MD, recently conducted a study that was presented at the 

2020 American Headache Society (AHS) Annual Meeting

 that not only evaluated the real-world efficacy, tolerability, and safety of ubrogepant (Ubrelvy; Allergan), rimegepant (Nurtec ODT; Biohaven), and lasmiditan (Reyvow; Eli Lilly), but headlined an overall trend of studies that evaluated previously FDA approved drugs. This time, the results of the trial were reported in a largely chronic migraine (81%) patient population.

The migraine community especially has seen drastic increase in number of options and treatments available for a multitude of differing migraine populations worldwide over the past decade. Chiang, a neurologist at Mayo Clinic in Phoenix, Arizona, noted that these types of studies are important for improving clinical care and reaching different subgroups of patients.

, Chiang describes the clinical importance of conducting real-world studies following drug approvals, as well as the future impact these data can have on clinical and patient care in migraine going forward.

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The neurologist at Mayo Clinic in Phoenix, Arizona, detailed the importance of further studies of FDA approved medications in different patient populations.

Chia-Chun Chiang, MD: Collecting Real-World Data Following FDA Approvals

“Those new medications really give us a lot of options to a large population of patients with migraine. So, this is definitely very exciting.”

, Chia-Chun Chiang, MD, presented her latest research, “Real World Efficacy, Tolerability and Safety of Ubrogepant, Rimegepant, and Lasmiditan.” While the preliminary results for rimegepant and lasmiditan are still under analysis, the premise of her research speaks to the growing landscape of migraine treatments over the past decade.

Ubrogepant was FDA approved as a first-in-class oral calcitonin gene-related peptide (CGRP) antagonist in December 2019, while 75-mg rimegepant was approved as an acute treatment of migraine in adults in early February this year. The third treatment, lasmiditan, is a selective serotonin 5-HT1F agonist approved for the acute treatment of migraine with or without aura in adults in October 2019.

Overall, the list of FDA approved migraine medications has seen steady growth in the past decade, allowing clinicians to have more options and choices for patient treatment. In an interview with 

, the neurologist at Mayo Clinic in Phoenix, Arizona, discussed the vast selection of migraine options, and how the positive impact it can have on clinical care.

The neurologist at Mayo Clinic in Phoenix, Arizona, discussed the growing variety of treatment options and the progress the migraine community has made on the management of this disease.

Chia-Chun Chiang, MD: Variations in FDA Approved Migraine Medications

“Additionally, consistent relief of pain for all treated attacks was experienced by 27% of patients. Those are very encouraging results and align very well with what was seen in ACHIEVE I and ACHIEVE II.”

2020 American Headache Society (AHS) Annual Scientific Meeting

, June 13, 2020, Chia-Chun Chiang, MD, presented data on a study that evaluated the real-world efficacy, safety, and tolerability of 3 FDA-approved migraine medications. While the results for rimegepant and lasmiditan are still being analyzed, she and her colleagues noted 18 of 57 (32%) patients had experienced headache freedom at 2 hours after taking ubrogepant for 1 or more attacks. 

The treatment was also found to provide pain relief for 1 or more attacks in 41 of the 57 patients (73%). Fatigure was the most common adverse event (AE) that was reported in 22% of patients. Most AEs were mild or moderate in severity. Dr. Chiang, a neurologist at Mayo Clinic in Phoenix, Arizona, told 

 that she sees similarities with what was observed in the ACHIEVE I and ACHIEVE II clinical trials.

In this interview, she breaks down the results of the trial in full detail, while comparing them to what has been previously observed to this point with ubrogepant.

Chiang C, Starling AJ, Dodick DW. Real world efficacy, tolerability and safety of ubrogepant, rimegepant, and lasmiditan. 

. 2020;60(S1 suppl). 1—156. doi: 10.1111/head.13854

The neurologist at Mayo Clinic in Phoenix, Arizona, detailed whether her and colleagues recent study results on ubrogepant aligned with previous study findings.

Author | Chia-Chun Chiang, MD

Articles

Chia-Chun Chiang, MD: Collecting Real-World Data Following FDA Approvals

Chia-Chun Chiang, MD: Variations in FDA Approved Migraine Medications

Chia-Chun Chiang, MD: Comparing Ubrogepant Study Results