Qulipta Added to OnabotulinumtoxinA Reduced Monthly Migraine Days in Chronic Migraine

The addition of Qulipta (atogepant; AbbVie, Chicago, IL) to onabotulinumtoxinA treatment was associated with reductions in migraine frequency and improved responder rates in adults with chronic migraine. The findings from a phase 3, open-label study (NCT05216263) presented at the 2026 American Academy of Neurology (AAN) Annual Meeting add to the limited evidence supporting combination preventive therapy in chronic migraine, an approach that is increasingly used in clinical practice.

In the 24-week, multicenter study, 75 participants receiving stable onabotulinumtoxinA (155–200 units) were treated with add-on Qulipta 60 mg once daily. Participants had a mean age of 48 years, 89% were women, and most had longstanding disease (mean duration, 15 years) with prior onabotulinumtoxinA use averaging 4 years. Primary end points included assessments of safety and efficacy, including changes in mean monthly migraine days (MMDs) and responder rates.

Key Findings

• Mean MMDs decreased by −6.45 from weeks 1 to 4, −6.89 from weeks 1 to 12, and −7.20 from weeks 13 to 24 compared with a baseline of 14.34 MMDs.
• A ≥50% reduction in MMDs was achieved by 54.2% of participants during weeks 1 to 12 and 61.9% during weeks 13 to 24.
• A ≥75% response rate was observed in 30.6% of participants during weeks 1 to 12 and 38.1% of participants during weeks 13 to 24.
• Treatment-emergent adverse events occurred in 65.3% of participants, most commonly constipation (16.0%), nausea (13.3%), and urinary tract infection (8.0%).
• Two serious adverse events were reported and were not considered treatment related.

Source

Lipton R. Safety, tolerability, and efficacy of atogepant added to onabotulinumtoxinA for the preventive treatment of chronic migraine: a phase 3, multicenter, 24-week, open-label study. Presented at: American Academy of Neurology Annual Meeting; April 18-22, 2026; Chicago, IL.