Patients in England are being offered a daily pill that could halve the frequency of migraines
Thousands of people in England suffering from migraines are being offered a daily pill by the NHS that can reduce the frequency of attacks by half.
In final draft guidance published on Thursday, the National Institute for Health and Care Excellence (Nice) has given the green light to the first oral treatment that can prevent both chronic and episodic migraines.
Atogepant – also called Aquipta and made by AbbVie – works by blocking the receptor of a protein found in the sensory nerves of the head and neck, known as calcitonin gene-related peptide (CGRP). CGRP causes blood vessels to dilate, which can lead to inflammation and migraines.
The guidance is expected to offer more choice to at least 170,000 patients in England, Nice said.
The regulator has recommended the drug as an option for preventing chronic and episodic migraines in adults who have had at least four migraine days per month and who have failed at least three previous preventive treatments.
With chronic migraine, a person has at least fifteen headache days per month, of which at least eight exhibit features of migraine. With episodic migraines, a person has fewer than 15 headache days per month.
Helen Knight, director of drug evaluation in Nice, said: “Currently the most effective options for people with chronic migraine who have already tried three preventive treatments are drugs that need to be injected.
“The committee heard from patient experts that some people cannot receive injectable treatments, for example because they have an allergy or phobia to needles.”
Knight said patients with chronic migraines – which occur on more than 15 days of the month – “would welcome an oral treatment”.
She added that Aquipta also “provides more choice” for those who suffer from episodic migraines, which occur on fewer than 15 days of the month.
Migraines affect around 4.5 million people in England and can have a significant impact on a person’s daily life, placing a heavy burden on the NHS and the wider economy.
Migraine charities called for “rapid” access to the drug to ensure patients with the debilitating condition can “benefit from it as soon as possible”.
The Migraine Trust’s chief executive, Rob Music, said: “A migraine attack can be incredibly debilitating. Symptoms may include intense headaches, loss or changes in the senses, and a lack of ability to carry out daily life.
“It’s positive to see even more therapies emerging for people with migraines, as many still rely on treatments developed for other conditions.
“We now need to ensure that access is fast so that migraine sufferers can benefit from it as quickly as possible.”
Health Minister Andrew Stephenson said: “Migraines affect millions of people in this country and this new treatment will help prevent recurring migraine attacks when other medicines have failed.
“It will enable more people whose daily lives are affected by this painful, debilitating condition to manage their migraines more effectively and live their lives to the fullest.”
Nice’s guidelines for England come after the pill was recommended for use in Scotland by the Scottish Medicines Consortium (SMC) in October last year.
Rachael Millward, medical director at AbbVie UK, said: “AbbVie has an extensive history in migraine research and is committed to addressing the unmet needs of people living with this debilitating condition.”
Nice’s recommendation means that suitable people with migraine will have access to an additional treatment option that has the potential to improve their quality of life, she added.
Nice recommends stopping Aquipta after twelve weeks if chronic migraine does not decrease by at least 30% and episodic migraine decreases by at least 50%.
If the final draft guidelines are not appealed, Nice is expected to publish final guidelines on the drug in May.