Exploring New Therapy Combinations to Treat Migraine: Richard B. Lipton, MD


The director of the Montefiore Headache Center discussed future aspirations and potential combinations that should be researched to treat patients with migraine.

"When you gather real-world evidence, your mission is to know how these combinations will work in the real-world. In a way, this design is very pertinent to the question that we’re asking on 1 hand. On the other hand, we don’t have a contemporaneous placebo group and don’t have random allocation of patients to treatment arms.”

At the 2021 American Headache Society (AHS) 63rd Scientific Annual Meeting, June 3-6, the design and interim findings from the Combining UbRogepAnt and Preventives for MiGrainE (COURAGE) study were presented by Richard B. Lipton, MD. The prospective, observational study evaluates the real-world effectiveness of ubrogepant (50 mg or 100 mg) for the acute treatment of migraine when used with onabotulinumtoxinA (Botox; Allergan/AbbVie) with a monoclonal antibody (mAb) or with both using data collected on the Migraine Buddy app.

The study consists of 3 arms: ubrogepant and calcitonin gene-related peptide mAb, ubrogepant and onabotulinumtoxinA, and ubrogepant and both onabotulinumtoxinA and CGRP mAb. While the results for the latter 2 arms have yet to be finalized, Lipton said there are a number of combinations outside of this study that should seek further exploration.

In an interview with NeurologyLive, Lipton, director of the Montefiore Headache Center, described the wide variety of layered treatment approaches investigators should consider examining, including the real-world effectiveness of multiple preventives and treatments that are fairly new to the market.

For more coverage of AHS 2021, click here.

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