New pill to prevent chronic migraines to be available on NHS
A new pill to prevent chronic and episodic migraines will be rolled out on the NHS, with some 170,000 sufferers eligible.
A migraine charity has called for “swift” access to the drug to ensure patients struggling with crippling headaches “can benefit from them as quickly as possible”.
Atogepant – sold under the brand name Aquipta and made by AbbVie – has been given the green light for NHS use under new final draft guidance from the National Institute for Health and Care Excellence (Nice).
Nice has previously backed other pills to prevent episodic and chronic migraines, with many sufferers struggling to find treatment that works for them.
Many of those in the chronic category – which means at least 15 days of attacks a month – end up having to resort to injections.
More choice for patients
Nice said the new pills offered more choice for patients, who are eligible if they have at least four migraine days per month and where at least three previous preventive treatments have failed.
The pill 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 makes blood vessels dilate, which can lead to inflammation and migraine.
The guidance is expected to give more choice to about 170,000 patients in England, Nice said.
Helen Knight, director of medicines evaluation at Nice, said: “Currently, the most effective options for people with chronic migraines who have already tried three preventative treatments are drugs that need to be injected.
“The committee heard from patient experts that some people cannot have injectable treatments, for example because they have an allergy or phobia of needles. So, some people with chronic migraines would welcome an oral treatment.”
She added that Aquipta also “offers more choice” for people who suffer episodic migraines, which happen on fewer than 15 days of the month.
‘Must ensure access is swift’
According to The Migraine Trust, about 10 million adults in the UK are living with the condition.
Rob Music, the charity’s chief executive, said: “A migraine attack can be incredibly debilitating.
“Symptoms can include intense head pain, loss of or changes to the senses, and lack of ability to carry out day-to-day life.
“It is positive to see even more therapies emerging for people with migraine as many still rely on treatments developed for other conditions.
“We now need to ensure access is swift, so that migraine patients can benefit from them as quickly as possible.”
Andrew Stephenson, the Health Minister, 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 allow more people whose daily life is affected by this painful, debilitating condition to manage their migraines more effectively and to live their lives to the fullest.”
Other drugs approved
Nice’s guidance for England comes after Aquipta was recommended for use in Scotland by the Scottish Medicines Consortium (SMC) in October last year.
Last year Nice backed a treatment called rimegepant to prevent episodic migraines.
The wafers dissolve under the tongue.
It has also backed the drugs topiramate or propranolol and amitriptyline for prevention of chronic migraines, with atogepant offered when these treatments had already been tried unsuccessfully.
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.
“The recommendation from Nice means that suitable people living with migraine in England and Wales will have access to an additional treatment option that has the potential to improve their quality of life.”
Nice recommends that Aquipta should be stopped after 12 weeks if chronic migraines do not reduce by at least 30 per cent and episodic migraine by at least 50 per cent.
If there are no appeals against its final draft guidance, Nice is expected to publish its final guidance on the drug next month.
