Ubrogepant maintains comparable efficacy and safety profiles irrespective of concurrent CGRP mAb use, according to results of the Phase 4 UNION trial. In the prospective, open label study, 165 participants were randomised to ubrogepant 50 mg or 100 mg, either alone or in combination with a CGRP mAb.
In patients taking ubrogepant 50 mg or 100 mg alone, 37.1% and 41.5% were pain free at 2 hours, respectively. In those also taking a CGRP mAb, pain freedom at 2 hours was 26.8% and 34.2% respectively. Freedom from most bothersome symptom at 2 hours occurred in 48.8% and 53.7% of patients in the ubrogepant 50 mg or 100 mg alone groups, respectively, and in 39.0% and 41.5% respectively in the groups also taking a CGRP mAb. Results for other endpoints were comparable with and without CGRP mAbs.
Adverse events rates were also similar in the ubrogepant alone and ubrogepant+CGRP mAb groups – 33.7% vs 36.6%, though nausea was more common with ubrogepant alone (19.3% vs 14.6%) and somnolence was less common (6% vs 9.8%).
“Ubrogepant maintains efficacy regardless of CGRP mAb use and we didn’t uncover any additive toxicity. The study supports flexible acute treatment strategies which is good news for patients, but of course further research is needed for long term combination outcomes,” concluded Dr Bradley Torphy, from the Chicago Headache Center and Research Institute, Chicago, USA.
References
Torphy B, Smith M, Lamba S et al. Evaluation of the safety and efficacy of ubrogepant in the acute treatment of migraine in patients also taking CGRP-targeting monoclonal antibodies. Presented at EHC 2025 (3-6 December 2025, Lisbon, Portugal) Abstract OP034
