Concomitant Use of Ubrogepant With CGRP Monoclonal Antibodies: Richard B. Lipton, MD

The director for the Montefiore Headache Center discussed the COURAGE study and how to effectively use a layered treatment approach with ubrogepant and CGRP monoclonal antibodies.

"My personal practice is to give gepants on top of monoclonal antibodies. There’s other evidence that suggest that this will work.”

The COmbining UbRogepAnt and Preventives for MiGrainE (COURAGE) study is a novel, application-based approach to assess the real-world effectiveness of ubrogepant (Ubrelvy; AbbVie) in reduction of pain, improvement of disability, and patient satisfaction when used concomitantly with calcitonin gene-related peptide (CGRP) monoclonal antibodies (mAbs). Interim findings from the first arm of the study were presented at the 2021 Virtual American Headache Society (AHS) 63rd Scientific Annual Meeting, June 3-6, by Richard B. Lipton, MD.

Results showed that real-world use of ubrogepant in addition to preventive treatment with a CGRP mAb produced high rates of meaningful pain relief (64.2% at 2 hours and 84.5% at 4 hours). The full analysis, which has yet to be released, will include data from multiple attacks, attacks treated with a second dose of ubrogepant, additional daily and 30-day effectiveness measures for use of ubrogepant with onabotulinumtoxinA (Botox; Allergan/AbbVie), and use of ubrogepant with both onabotulinumtoxinA and CGRP mAbs.

Lipton, director for the Montefiore Headache Center, sat down with NeurologyLive to discuss the background of the study and its purpose, the main outcomes observed, and whether clinicians can immediately incorporate the findings into their clinical care practice.

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