Trial Outcomes & Findings for Comparative Study of Oral Atogepant Versus Oral Topiramate to Assess Adverse Events in Adult Participants With Migraine (NCT NCT05748483)

NCT ID: NCT05748483

Last Updated: 2026-07-02

Results Overview

An adverse event (AE) is defined as any untoward medical occurrence in a patient or clinical investigation participant administered a pharmaceutical product which does not necessarily have a causal relationship with this treatment. The investigator assesses the relationship of each event to the use of study drug. Treatment-emergent adverse events (TEAEs) are defined as any AE with an onset date on or after the date of first dose of study drug during the Double Blind (DB) treatment period; and on or before the date of last dose of study drug during the DB treatment period (including tapering off phase, if applicable) + 30 days; and before the date of first dose of study drug during the Open Label (OL) treatment period, if applicable.

Recruitment status

COMPLETED

Study phase

PHASE3

Target enrollment

545 participants

Primary outcome timeframe

Week 24

Results posted on

2026-07-02

Participant Flow

Participant milestones

Participant milestones
Measure
DB: Topiramate
Double Blind Period (DB): Participants will receive topiramate oral capsule (up to highest dose tolerated: 50, 75, or 100 mg/day) either once daily (QD) or twice daily (BID) and placebo for atogepant oral tablet for 24 weeks.
DB: Atogepant
Double Blind Period (DB): Participants will receive atogepant 60 mg oral tablets once daily (QD) and placebo for topiramate for 24 weeks.
OL: Atogepant
Open Label (OL) Period: Starting at week 25, eligible participants from either arm the DB period will receive atogepant 60 mg oral tablets QD for 52 weeks.
Double Blind (DB) Period
STARTED
272
273
0
Double Blind (DB) Period
Treated
267
273
0
Double Blind (DB) Period
COMPLETED
230
241
0
Double Blind (DB) Period
NOT COMPLETED
42
32
0
Open Label (OL) Period
STARTED
0
0
457
Open Label (OL) Period
COMPLETED
0
0
0
Open Label (OL) Period
NOT COMPLETED
0
0
457

Reasons for withdrawal

Reasons for withdrawal
Measure
DB: Topiramate
Double Blind Period (DB): Participants will receive topiramate oral capsule (up to highest dose tolerated: 50, 75, or 100 mg/day) either once daily (QD) or twice daily (BID) and placebo for atogepant oral tablet for 24 weeks.
DB: Atogepant
Double Blind Period (DB): Participants will receive atogepant 60 mg oral tablets once daily (QD) and placebo for topiramate for 24 weeks.
OL: Atogepant
Open Label (OL) Period: Starting at week 25, eligible participants from either arm the DB period will receive atogepant 60 mg oral tablets QD for 52 weeks.
Double Blind (DB) Period
Lost to Follow-up
2
2
0
Double Blind (DB) Period
Withdrawal by Subject
30
26
0
Double Blind (DB) Period
Other
10
4
0
Open Label (OL) Period
Ongoing at Time of Analysis
0
0
457

Baseline Characteristics

Comparative Study of Oral Atogepant Versus Oral Topiramate to Assess Adverse Events in Adult Participants With Migraine

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Topiramate
n=272 Participants
Double Blind Period (DB): Participants will receive topiramate oral capsule (up to highest dose tolerated: 50, 75, or 100 mg/day) either once daily (QD) or twice daily (BID) and placebo for atogepant oral tablet for 24 weeks.
Atogepant
n=273 Participants
Double Blind Period (DB): Participants will receive atogepant 60 mg oral tablets once daily (QD) and placebo for topiramate for 24 weeks.
Total
n=545 Participants
Total of all reporting groups
Age, Continuous
40.1 years
STANDARD_DEVIATION 12.29 • n=20 Participants
39.2 years
STANDARD_DEVIATION 11.91 • n=20 Participants
39.7 years
STANDARD_DEVIATION 12.10 • n=40 Participants
Sex: Female, Male
Female
244 Participants
n=20 Participants
240 Participants
n=20 Participants
484 Participants
n=40 Participants
Sex: Female, Male
Male
28 Participants
n=20 Participants
33 Participants
n=20 Participants
61 Participants
n=40 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
11 Participants
n=20 Participants
12 Participants
n=20 Participants
23 Participants
n=40 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
261 Participants
n=20 Participants
261 Participants
n=20 Participants
522 Participants
n=40 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants
n=20 Participants
0 Participants
n=20 Participants
0 Participants
n=40 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=20 Participants
1 Participants
n=20 Participants
1 Participants
n=40 Participants
Race (NIH/OMB)
Asian
8 Participants
n=20 Participants
4 Participants
n=20 Participants
12 Participants
n=40 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=20 Participants
1 Participants
n=20 Participants
1 Participants
n=40 Participants
Race (NIH/OMB)
Black or African American
2 Participants
n=20 Participants
3 Participants
n=20 Participants
5 Participants
n=40 Participants
Race (NIH/OMB)
White
261 Participants
n=20 Participants
261 Participants
n=20 Participants
522 Participants
n=40 Participants
Race (NIH/OMB)
More than one race
1 Participants
n=20 Participants
3 Participants
n=20 Participants
4 Participants
n=40 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
n=20 Participants
0 Participants
n=20 Participants
0 Participants
n=40 Participants

PRIMARY outcome

Timeframe: Week 24

Population: Safety Population 1 - All participants who received at least 1 dose of study treatment during the DB treatment period. Here, 'Overall Number of Participants Analyzed' is the number of participants evaluable for this Endpoint.

An adverse event (AE) is defined as any untoward medical occurrence in a patient or clinical investigation participant administered a pharmaceutical product which does not necessarily have a causal relationship with this treatment. The investigator assesses the relationship of each event to the use of study drug. Treatment-emergent adverse events (TEAEs) are defined as any AE with an onset date on or after the date of first dose of study drug during the Double Blind (DB) treatment period; and on or before the date of last dose of study drug during the DB treatment period (including tapering off phase, if applicable) + 30 days; and before the date of first dose of study drug during the Open Label (OL) treatment period, if applicable.

Outcome measures

Outcome measures
Measure
Topiramate
n=267 Participants
Double Blind Period (DB): Participants will receive topiramate oral capsule (up to highest dose tolerated: 50, 75, or 100 mg/day) either once daily (QD) or twice daily (BID) and placebo for atogepant oral tablet for 24 weeks.
Atogepant
n=273 Participants
Double Blind Period (DB): Participants will receive atogepant 60 mg oral tablets once daily (QD) and placebo for topiramate for 24 weeks.
Percentage of Participants Who Discontinued Treatment Due to Treatment-Emergent Adverse Events (TEAEs)
29.6 percentage of participants
12.1 percentage of participants

SECONDARY outcome

Timeframe: Months 4 to 6 (DB Period)

Population: Modified Intent-to-Treat (mITT) Population - all randomized participants who received at least 1 dose of study drug, had an evaluable baseline period of eDiary data and had at least 1 evaluable post-baseline 4-week (1 month) period of eDiary data within 24 weeks after the first dose of study drug (Month 1 to Month 6), regardless of whether on study drug or off study drug.

The mean monthly migraine days across Months 4 to 6 is calculated by taking the 3-month average of monthly migraine days over Months 4 to 6. The monthly migraine days is defined as the total number of recorded migraine days in the eDiary divided by the total number of days with eDiary records during each monthly period and multiplied by 28. The responder status of 50% reduction from Baseline is defined as a participant with at least a 50% reduction from Baseline in the 3-month average of monthly migraine days over Months 4 to 6.

Outcome measures

Outcome measures
Measure
Topiramate
n=257 Participants
Double Blind Period (DB): Participants will receive topiramate oral capsule (up to highest dose tolerated: 50, 75, or 100 mg/day) either once daily (QD) or twice daily (BID) and placebo for atogepant oral tablet for 24 weeks.
Atogepant
n=270 Participants
Double Blind Period (DB): Participants will receive atogepant 60 mg oral tablets once daily (QD) and placebo for topiramate for 24 weeks.
Percentage of Participants Achieving ≥ 50% Improvement (Reduction) in Mean Monthly Migraine Days (MMD) During Months 4 to 6 (DB Period)
39.3 percentage of participants
64.1 percentage of participants

SECONDARY outcome

Timeframe: Baseline to Month 4 to Month 6 (DB Period)

Population: Modified Intent-to-Treat (mITT) Population - all randomized participants who received at least 1 dose of study drug, had an evaluable baseline period of eDiary data and had at least 1 evaluable post-baseline 4-week (1 month) period of eDiary data within 24 weeks after the first dose of study drug (Month 1 to Month 6), regardless of whether on study drug or off study drug. Here, 'Overall Number of Participants Analyzed' is the number of participants evaluable for this Endpoint.

The mean monthly migraine days across Months 4 to 6 is calculated by taking the 3-month average of monthly migraine days over Months 4 to 6. The monthly migraine days is defined as the total number of recorded migraine days in the eDiary divided by the total number of days with eDiary records during each monthly period and multiplied by 28.

Outcome measures

Outcome measures
Measure
Topiramate
n=236 Participants
Double Blind Period (DB): Participants will receive topiramate oral capsule (up to highest dose tolerated: 50, 75, or 100 mg/day) either once daily (QD) or twice daily (BID) and placebo for atogepant oral tablet for 24 weeks.
Atogepant
n=245 Participants
Double Blind Period (DB): Participants will receive atogepant 60 mg oral tablets once daily (QD) and placebo for topiramate for 24 weeks.
Change From Baseline in Mean Monthly Migraine Days During Months 4 to 6 (DB Period)
-4.49 mean monthly migraine days
Standard Error 0.268
-6.27 mean monthly migraine days
Standard Error 0.263

SECONDARY outcome

Timeframe: Baseline to Week 24

Population: Modified Intent-to-Treat (mITT) Population - all randomized participants who received at least 1 dose of study drug, had an evaluable baseline period of eDiary data and had at least 1 evaluable post-baseline 4-week (1 month) period of eDiary data within 24 weeks after the first dose of study drug (Month 1 to Month 6), regardless of whether on study drug or off study drug. Here, 'Overall Number of Participants Analyzed' is the number of participants evaluable for this Endpoint.

The HIT-6 is a 6-item assessment used to measure the impact headaches have on a participant's ability to function on the job, at school, at home and in social situations. It assesses the effect that headaches have on normal daily life and the subject's ability to function. Responses are based on frequency using a 5-point scale ranging from "never" to "always." The HIT-6 total score, which ranges from 36 to 78, is the sum of the responses, each of which is assigned a score ranging from 6 points (never) to 13 points (always). Negative changes from Baseline in the HIT-6 score indicate improvement.

Outcome measures

Outcome measures
Measure
Topiramate
n=218 Participants
Double Blind Period (DB): Participants will receive topiramate oral capsule (up to highest dose tolerated: 50, 75, or 100 mg/day) either once daily (QD) or twice daily (BID) and placebo for atogepant oral tablet for 24 weeks.
Atogepant
n=227 Participants
Double Blind Period (DB): Participants will receive atogepant 60 mg oral tablets once daily (QD) and placebo for topiramate for 24 weeks.
Change From Baseline in the Total 6-Item Headache Impact Test (HIT-6) Score at Week 24
-7.4 score on a scale
Standard Error 0.58
-11.7 score on a scale
Standard Error 0.57

SECONDARY outcome

Timeframe: Baseline to Week 24

Population: Modified Intent-to-Treat (mITT) Population - all randomized participants who received at least 1 dose of study drug, had an evaluable baseline period of eDiary data and had at least 1 evaluable post-baseline 4-week (1 month) period of eDiary data within 24 weeks after the first dose of study drug (Month 1 to Month 6), regardless of whether on study drug or off study drug. Here, 'Overall Number of Participants Analyzed' is the number of participants evaluable for this Endpoint.

MSQ v2.1 is a 14-item questionnaire designed to measure health-related quality of life impairments attributed to migraine in the past 4 weeks. It is divided into three domains: Role Function Restrictive, Role Function Preventive, and Emotional Function domain. Participants respond to items using a 6-point scale ranging from "none of the time" to "all of the time." Raw dimension scores are computed as a sum of item responses and rescaled to a 0 to 100 scale, where higher scores indicate better quality of life.

Outcome measures

Outcome measures
Measure
Topiramate
n=217 Participants
Double Blind Period (DB): Participants will receive topiramate oral capsule (up to highest dose tolerated: 50, 75, or 100 mg/day) either once daily (QD) or twice daily (BID) and placebo for atogepant oral tablet for 24 weeks.
Atogepant
n=226 Participants
Double Blind Period (DB): Participants will receive atogepant 60 mg oral tablets once daily (QD) and placebo for topiramate for 24 weeks.
Change From Baseline in Migraine-Specific Quality of Life Questionnaire Version 2.1 (MSQ v2.1) Role Function - Restrictive (RFR) Domain Score At Week 24
23.1 units on a scale
Standard Error 1.43
33.5 units on a scale
Standard Error 1.40

SECONDARY outcome

Timeframe: Week 24

Population: Modified Intent-to-Treat (mITT) Population - all randomized participants who received at least 1 dose of study drug, had an evaluable baseline period of eDiary data and had at least 1 evaluable post-baseline 4-week (1 month) period of eDiary data within 24 weeks after the first dose of study drug (Month 1 to Month 6), regardless of whether on study drug or off study drug.

The Patient Global Impression of Change (PGIC) is a 7-point response scale. The participant response to the question, "Since you started the study treatment, how would you rate the change in your overall condition?" was assessed. Scores ranged from 1-7 on a scale of 1 (very much improved) to 7 (very much worse). Higher values represent a worse outcome.

Outcome measures

Outcome measures
Measure
Topiramate
n=257 Participants
Double Blind Period (DB): Participants will receive topiramate oral capsule (up to highest dose tolerated: 50, 75, or 100 mg/day) either once daily (QD) or twice daily (BID) and placebo for atogepant oral tablet for 24 weeks.
Atogepant
n=270 Participants
Double Blind Period (DB): Participants will receive atogepant 60 mg oral tablets once daily (QD) and placebo for topiramate for 24 weeks.
Percentage of Participants Achieving a Rating of "Much Better" or "Very Much Better" Assessed by the Patient Global Impression of Change (PGIC)
37.4 percentage of participants
68.9 percentage of participants

SECONDARY outcome

Timeframe: Baseline to Week 6

Population: Modified Intent-to-Treat (mITT) Population - all randomized participants who received at least 1 dose of study drug, had an evaluable baseline period of eDiary data and had at least 1 evaluable post-baseline 4-week (1 month) period of eDiary data within 24 weeks after the first dose of study drug (Month 1 to Month 6), regardless of whether on study drug or off study drug. Here, 'Overall Number of Participants Analyzed' is the number of participants evaluable for this Endpoint.

The Patient Reported Outcomes Measurement Information System (PROMIS®) Cognitive Function and Cognitive Function Abilities Subset item banks assess patient perceived cognitive deficits (i.e., mental acuity, concentration, verbal and nonverbal memory, verbal fluency, and perceived changes) over the past 7 days. A 5-level response scale for all 6 items ranges from 1 (Not at all) to 5 (Very much). The raw score of PROMIS-CF is the sum of all 6 items, ranging from 6 to 30. The raw score is standardized into a T-score with a mean of 50 and standard deviation of 10. Higher scores indicate a better cognitive function.

Outcome measures

Outcome measures
Measure
Topiramate
n=142 Participants
Double Blind Period (DB): Participants will receive topiramate oral capsule (up to highest dose tolerated: 50, 75, or 100 mg/day) either once daily (QD) or twice daily (BID) and placebo for atogepant oral tablet for 24 weeks.
Atogepant
n=184 Participants
Double Blind Period (DB): Participants will receive atogepant 60 mg oral tablets once daily (QD) and placebo for topiramate for 24 weeks.
Change From Baseline in Patient-Reported Outcomes Measurement Information System (PROMIS) Cognitive Function - Abilities Subset - Short Form 6a Version 2.0 Score
0.2 T-score
Standard Error 0.64
5.2 T-score
Standard Error 0.60

Adverse Events

DB: Topiramate

Serious events: 3 serious events
Other events: 189 other events
Deaths: 0 deaths

DB: Atogepant

Serious events: 7 serious events
Other events: 154 other events
Deaths: 0 deaths

OL: Atogepant

Serious events: 8 serious events
Other events: 61 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
DB: Topiramate
n=272 participants at risk
Double Blind Period (DB): Participants will receive topiramate oral capsule (up to highest dose tolerated: 50, 75, or 100 mg/day) either once daily (QD) or twice daily (BID) and placebo for atogepant oral tablet for 24 weeks.
DB: Atogepant
n=273 participants at risk
Double Blind Period (DB): Participants will receive atogepant 60 mg oral tablets once daily (QD) and placebo for topiramate for 24 weeks.
OL: Atogepant
n=457 participants at risk
Open Label (OL) Period: Starting at week 25, eligible participants from either arm the DB period will receive atogepant 60 mg oral tablets QD for 52 weeks.
Cardiac disorders
BRADYCARDIA
0.00%
0/272 • All-cause mortality and adverse event tables include events reported from the time of informed consent until time of interim analysis. The median time on follow-up (or mean time participants were followed) was 168.0, 168.0, and 166.0 days for arms DB: Atogepant, DB: Topiramate, and OL: Atogepant, respectively.
0.37%
1/273 • Number of events 1 • All-cause mortality and adverse event tables include events reported from the time of informed consent until time of interim analysis. The median time on follow-up (or mean time participants were followed) was 168.0, 168.0, and 166.0 days for arms DB: Atogepant, DB: Topiramate, and OL: Atogepant, respectively.
0.00%
0/457 • All-cause mortality and adverse event tables include events reported from the time of informed consent until time of interim analysis. The median time on follow-up (or mean time participants were followed) was 168.0, 168.0, and 166.0 days for arms DB: Atogepant, DB: Topiramate, and OL: Atogepant, respectively.
Gastrointestinal disorders
COLITIS
0.00%
0/272 • All-cause mortality and adverse event tables include events reported from the time of informed consent until time of interim analysis. The median time on follow-up (or mean time participants were followed) was 168.0, 168.0, and 166.0 days for arms DB: Atogepant, DB: Topiramate, and OL: Atogepant, respectively.
0.00%
0/273 • All-cause mortality and adverse event tables include events reported from the time of informed consent until time of interim analysis. The median time on follow-up (or mean time participants were followed) was 168.0, 168.0, and 166.0 days for arms DB: Atogepant, DB: Topiramate, and OL: Atogepant, respectively.
0.22%
1/457 • Number of events 1 • All-cause mortality and adverse event tables include events reported from the time of informed consent until time of interim analysis. The median time on follow-up (or mean time participants were followed) was 168.0, 168.0, and 166.0 days for arms DB: Atogepant, DB: Topiramate, and OL: Atogepant, respectively.
Gastrointestinal disorders
DYSPEPSIA
0.00%
0/272 • All-cause mortality and adverse event tables include events reported from the time of informed consent until time of interim analysis. The median time on follow-up (or mean time participants were followed) was 168.0, 168.0, and 166.0 days for arms DB: Atogepant, DB: Topiramate, and OL: Atogepant, respectively.
0.37%
1/273 • Number of events 1 • All-cause mortality and adverse event tables include events reported from the time of informed consent until time of interim analysis. The median time on follow-up (or mean time participants were followed) was 168.0, 168.0, and 166.0 days for arms DB: Atogepant, DB: Topiramate, and OL: Atogepant, respectively.
0.00%
0/457 • All-cause mortality and adverse event tables include events reported from the time of informed consent until time of interim analysis. The median time on follow-up (or mean time participants were followed) was 168.0, 168.0, and 166.0 days for arms DB: Atogepant, DB: Topiramate, and OL: Atogepant, respectively.
General disorders
INFLAMMATION
0.00%
0/272 • All-cause mortality and adverse event tables include events reported from the time of informed consent until time of interim analysis. The median time on follow-up (or mean time participants were followed) was 168.0, 168.0, and 166.0 days for arms DB: Atogepant, DB: Topiramate, and OL: Atogepant, respectively.
0.00%
0/273 • All-cause mortality and adverse event tables include events reported from the time of informed consent until time of interim analysis. The median time on follow-up (or mean time participants were followed) was 168.0, 168.0, and 166.0 days for arms DB: Atogepant, DB: Topiramate, and OL: Atogepant, respectively.
0.22%
1/457 • Number of events 1 • All-cause mortality and adverse event tables include events reported from the time of informed consent until time of interim analysis. The median time on follow-up (or mean time participants were followed) was 168.0, 168.0, and 166.0 days for arms DB: Atogepant, DB: Topiramate, and OL: Atogepant, respectively.
Immune system disorders
ANAPHYLACTIC REACTION
0.00%
0/272 • All-cause mortality and adverse event tables include events reported from the time of informed consent until time of interim analysis. The median time on follow-up (or mean time participants were followed) was 168.0, 168.0, and 166.0 days for arms DB: Atogepant, DB: Topiramate, and OL: Atogepant, respectively.
0.37%
1/273 • Number of events 1 • All-cause mortality and adverse event tables include events reported from the time of informed consent until time of interim analysis. The median time on follow-up (or mean time participants were followed) was 168.0, 168.0, and 166.0 days for arms DB: Atogepant, DB: Topiramate, and OL: Atogepant, respectively.
0.00%
0/457 • All-cause mortality and adverse event tables include events reported from the time of informed consent until time of interim analysis. The median time on follow-up (or mean time participants were followed) was 168.0, 168.0, and 166.0 days for arms DB: Atogepant, DB: Topiramate, and OL: Atogepant, respectively.
Infections and infestations
APPENDICITIS
0.00%
0/272 • All-cause mortality and adverse event tables include events reported from the time of informed consent until time of interim analysis. The median time on follow-up (or mean time participants were followed) was 168.0, 168.0, and 166.0 days for arms DB: Atogepant, DB: Topiramate, and OL: Atogepant, respectively.
0.37%
1/273 • Number of events 1 • All-cause mortality and adverse event tables include events reported from the time of informed consent until time of interim analysis. The median time on follow-up (or mean time participants were followed) was 168.0, 168.0, and 166.0 days for arms DB: Atogepant, DB: Topiramate, and OL: Atogepant, respectively.
0.00%
0/457 • All-cause mortality and adverse event tables include events reported from the time of informed consent until time of interim analysis. The median time on follow-up (or mean time participants were followed) was 168.0, 168.0, and 166.0 days for arms DB: Atogepant, DB: Topiramate, and OL: Atogepant, respectively.
Infections and infestations
PYELONEPHRITIS ACUTE
0.00%
0/272 • All-cause mortality and adverse event tables include events reported from the time of informed consent until time of interim analysis. The median time on follow-up (or mean time participants were followed) was 168.0, 168.0, and 166.0 days for arms DB: Atogepant, DB: Topiramate, and OL: Atogepant, respectively.
0.00%
0/273 • All-cause mortality and adverse event tables include events reported from the time of informed consent until time of interim analysis. The median time on follow-up (or mean time participants were followed) was 168.0, 168.0, and 166.0 days for arms DB: Atogepant, DB: Topiramate, and OL: Atogepant, respectively.
0.22%
1/457 • Number of events 1 • All-cause mortality and adverse event tables include events reported from the time of informed consent until time of interim analysis. The median time on follow-up (or mean time participants were followed) was 168.0, 168.0, and 166.0 days for arms DB: Atogepant, DB: Topiramate, and OL: Atogepant, respectively.
Injury, poisoning and procedural complications
CARTILAGE INJURY
0.37%
1/272 • Number of events 1 • All-cause mortality and adverse event tables include events reported from the time of informed consent until time of interim analysis. The median time on follow-up (or mean time participants were followed) was 168.0, 168.0, and 166.0 days for arms DB: Atogepant, DB: Topiramate, and OL: Atogepant, respectively.
0.00%
0/273 • All-cause mortality and adverse event tables include events reported from the time of informed consent until time of interim analysis. The median time on follow-up (or mean time participants were followed) was 168.0, 168.0, and 166.0 days for arms DB: Atogepant, DB: Topiramate, and OL: Atogepant, respectively.
0.00%
0/457 • All-cause mortality and adverse event tables include events reported from the time of informed consent until time of interim analysis. The median time on follow-up (or mean time participants were followed) was 168.0, 168.0, and 166.0 days for arms DB: Atogepant, DB: Topiramate, and OL: Atogepant, respectively.
Injury, poisoning and procedural complications
EPICONDYLITIS
0.00%
0/272 • All-cause mortality and adverse event tables include events reported from the time of informed consent until time of interim analysis. The median time on follow-up (or mean time participants were followed) was 168.0, 168.0, and 166.0 days for arms DB: Atogepant, DB: Topiramate, and OL: Atogepant, respectively.
0.00%
0/273 • All-cause mortality and adverse event tables include events reported from the time of informed consent until time of interim analysis. The median time on follow-up (or mean time participants were followed) was 168.0, 168.0, and 166.0 days for arms DB: Atogepant, DB: Topiramate, and OL: Atogepant, respectively.
0.22%
1/457 • Number of events 1 • All-cause mortality and adverse event tables include events reported from the time of informed consent until time of interim analysis. The median time on follow-up (or mean time participants were followed) was 168.0, 168.0, and 166.0 days for arms DB: Atogepant, DB: Topiramate, and OL: Atogepant, respectively.
Injury, poisoning and procedural complications
ULNA FRACTURE
0.00%
0/272 • All-cause mortality and adverse event tables include events reported from the time of informed consent until time of interim analysis. The median time on follow-up (or mean time participants were followed) was 168.0, 168.0, and 166.0 days for arms DB: Atogepant, DB: Topiramate, and OL: Atogepant, respectively.
0.37%
1/273 • Number of events 1 • All-cause mortality and adverse event tables include events reported from the time of informed consent until time of interim analysis. The median time on follow-up (or mean time participants were followed) was 168.0, 168.0, and 166.0 days for arms DB: Atogepant, DB: Topiramate, and OL: Atogepant, respectively.
0.00%
0/457 • All-cause mortality and adverse event tables include events reported from the time of informed consent until time of interim analysis. The median time on follow-up (or mean time participants were followed) was 168.0, 168.0, and 166.0 days for arms DB: Atogepant, DB: Topiramate, and OL: Atogepant, respectively.
Musculoskeletal and connective tissue disorders
BACK PAIN
0.37%
1/272 • Number of events 1 • All-cause mortality and adverse event tables include events reported from the time of informed consent until time of interim analysis. The median time on follow-up (or mean time participants were followed) was 168.0, 168.0, and 166.0 days for arms DB: Atogepant, DB: Topiramate, and OL: Atogepant, respectively.
0.00%
0/273 • All-cause mortality and adverse event tables include events reported from the time of informed consent until time of interim analysis. The median time on follow-up (or mean time participants were followed) was 168.0, 168.0, and 166.0 days for arms DB: Atogepant, DB: Topiramate, and OL: Atogepant, respectively.
0.00%
0/457 • All-cause mortality and adverse event tables include events reported from the time of informed consent until time of interim analysis. The median time on follow-up (or mean time participants were followed) was 168.0, 168.0, and 166.0 days for arms DB: Atogepant, DB: Topiramate, and OL: Atogepant, respectively.
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
GLIOMA
0.00%
0/272 • All-cause mortality and adverse event tables include events reported from the time of informed consent until time of interim analysis. The median time on follow-up (or mean time participants were followed) was 168.0, 168.0, and 166.0 days for arms DB: Atogepant, DB: Topiramate, and OL: Atogepant, respectively.
0.00%
0/273 • All-cause mortality and adverse event tables include events reported from the time of informed consent until time of interim analysis. The median time on follow-up (or mean time participants were followed) was 168.0, 168.0, and 166.0 days for arms DB: Atogepant, DB: Topiramate, and OL: Atogepant, respectively.
0.22%
1/457 • Number of events 1 • All-cause mortality and adverse event tables include events reported from the time of informed consent until time of interim analysis. The median time on follow-up (or mean time participants were followed) was 168.0, 168.0, and 166.0 days for arms DB: Atogepant, DB: Topiramate, and OL: Atogepant, respectively.
Nervous system disorders
HEADACHE
0.00%
0/272 • All-cause mortality and adverse event tables include events reported from the time of informed consent until time of interim analysis. The median time on follow-up (or mean time participants were followed) was 168.0, 168.0, and 166.0 days for arms DB: Atogepant, DB: Topiramate, and OL: Atogepant, respectively.
0.00%
0/273 • All-cause mortality and adverse event tables include events reported from the time of informed consent until time of interim analysis. The median time on follow-up (or mean time participants were followed) was 168.0, 168.0, and 166.0 days for arms DB: Atogepant, DB: Topiramate, and OL: Atogepant, respectively.
0.22%
1/457 • Number of events 1 • All-cause mortality and adverse event tables include events reported from the time of informed consent until time of interim analysis. The median time on follow-up (or mean time participants were followed) was 168.0, 168.0, and 166.0 days for arms DB: Atogepant, DB: Topiramate, and OL: Atogepant, respectively.
Nervous system disorders
MIGRAINE
0.37%
1/272 • Number of events 1 • All-cause mortality and adverse event tables include events reported from the time of informed consent until time of interim analysis. The median time on follow-up (or mean time participants were followed) was 168.0, 168.0, and 166.0 days for arms DB: Atogepant, DB: Topiramate, and OL: Atogepant, respectively.
0.00%
0/273 • All-cause mortality and adverse event tables include events reported from the time of informed consent until time of interim analysis. The median time on follow-up (or mean time participants were followed) was 168.0, 168.0, and 166.0 days for arms DB: Atogepant, DB: Topiramate, and OL: Atogepant, respectively.
0.00%
0/457 • All-cause mortality and adverse event tables include events reported from the time of informed consent until time of interim analysis. The median time on follow-up (or mean time participants were followed) was 168.0, 168.0, and 166.0 days for arms DB: Atogepant, DB: Topiramate, and OL: Atogepant, respectively.
Nervous system disorders
THUNDERCLAP HEADACHE
0.00%
0/272 • All-cause mortality and adverse event tables include events reported from the time of informed consent until time of interim analysis. The median time on follow-up (or mean time participants were followed) was 168.0, 168.0, and 166.0 days for arms DB: Atogepant, DB: Topiramate, and OL: Atogepant, respectively.
0.37%
1/273 • Number of events 1 • All-cause mortality and adverse event tables include events reported from the time of informed consent until time of interim analysis. The median time on follow-up (or mean time participants were followed) was 168.0, 168.0, and 166.0 days for arms DB: Atogepant, DB: Topiramate, and OL: Atogepant, respectively.
0.00%
0/457 • All-cause mortality and adverse event tables include events reported from the time of informed consent until time of interim analysis. The median time on follow-up (or mean time participants were followed) was 168.0, 168.0, and 166.0 days for arms DB: Atogepant, DB: Topiramate, and OL: Atogepant, respectively.
Psychiatric disorders
MIXED ANXIETY AND DEPRESSIVE DISORDER
0.00%
0/272 • All-cause mortality and adverse event tables include events reported from the time of informed consent until time of interim analysis. The median time on follow-up (or mean time participants were followed) was 168.0, 168.0, and 166.0 days for arms DB: Atogepant, DB: Topiramate, and OL: Atogepant, respectively.
0.37%
1/273 • Number of events 1 • All-cause mortality and adverse event tables include events reported from the time of informed consent until time of interim analysis. The median time on follow-up (or mean time participants were followed) was 168.0, 168.0, and 166.0 days for arms DB: Atogepant, DB: Topiramate, and OL: Atogepant, respectively.
0.00%
0/457 • All-cause mortality and adverse event tables include events reported from the time of informed consent until time of interim analysis. The median time on follow-up (or mean time participants were followed) was 168.0, 168.0, and 166.0 days for arms DB: Atogepant, DB: Topiramate, and OL: Atogepant, respectively.
Renal and urinary disorders
RENAL FAILURE
0.00%
0/272 • All-cause mortality and adverse event tables include events reported from the time of informed consent until time of interim analysis. The median time on follow-up (or mean time participants were followed) was 168.0, 168.0, and 166.0 days for arms DB: Atogepant, DB: Topiramate, and OL: Atogepant, respectively.
0.00%
0/273 • All-cause mortality and adverse event tables include events reported from the time of informed consent until time of interim analysis. The median time on follow-up (or mean time participants were followed) was 168.0, 168.0, and 166.0 days for arms DB: Atogepant, DB: Topiramate, and OL: Atogepant, respectively.
0.22%
1/457 • Number of events 1 • All-cause mortality and adverse event tables include events reported from the time of informed consent until time of interim analysis. The median time on follow-up (or mean time participants were followed) was 168.0, 168.0, and 166.0 days for arms DB: Atogepant, DB: Topiramate, and OL: Atogepant, respectively.
Reproductive system and breast disorders
UTEROVAGINAL PROLAPSE
0.00%
0/272 • All-cause mortality and adverse event tables include events reported from the time of informed consent until time of interim analysis. The median time on follow-up (or mean time participants were followed) was 168.0, 168.0, and 166.0 days for arms DB: Atogepant, DB: Topiramate, and OL: Atogepant, respectively.
0.00%
0/273 • All-cause mortality and adverse event tables include events reported from the time of informed consent until time of interim analysis. The median time on follow-up (or mean time participants were followed) was 168.0, 168.0, and 166.0 days for arms DB: Atogepant, DB: Topiramate, and OL: Atogepant, respectively.
0.22%
1/457 • Number of events 1 • All-cause mortality and adverse event tables include events reported from the time of informed consent until time of interim analysis. The median time on follow-up (or mean time participants were followed) was 168.0, 168.0, and 166.0 days for arms DB: Atogepant, DB: Topiramate, and OL: Atogepant, respectively.

Other adverse events

Other adverse events
Measure
DB: Topiramate
n=272 participants at risk
Double Blind Period (DB): Participants will receive topiramate oral capsule (up to highest dose tolerated: 50, 75, or 100 mg/day) either once daily (QD) or twice daily (BID) and placebo for atogepant oral tablet for 24 weeks.
DB: Atogepant
n=273 participants at risk
Double Blind Period (DB): Participants will receive atogepant 60 mg oral tablets once daily (QD) and placebo for topiramate for 24 weeks.
OL: Atogepant
n=457 participants at risk
Open Label (OL) Period: Starting at week 25, eligible participants from either arm the DB period will receive atogepant 60 mg oral tablets QD for 52 weeks.
Gastrointestinal disorders
CONSTIPATION
4.8%
13/272 • Number of events 14 • All-cause mortality and adverse event tables include events reported from the time of informed consent until time of interim analysis. The median time on follow-up (or mean time participants were followed) was 168.0, 168.0, and 166.0 days for arms DB: Atogepant, DB: Topiramate, and OL: Atogepant, respectively.
9.9%
27/273 • Number of events 30 • All-cause mortality and adverse event tables include events reported from the time of informed consent until time of interim analysis. The median time on follow-up (or mean time participants were followed) was 168.0, 168.0, and 166.0 days for arms DB: Atogepant, DB: Topiramate, and OL: Atogepant, respectively.
5.5%
25/457 • Number of events 25 • All-cause mortality and adverse event tables include events reported from the time of informed consent until time of interim analysis. The median time on follow-up (or mean time participants were followed) was 168.0, 168.0, and 166.0 days for arms DB: Atogepant, DB: Topiramate, and OL: Atogepant, respectively.
Gastrointestinal disorders
NAUSEA
16.2%
44/272 • Number of events 48 • All-cause mortality and adverse event tables include events reported from the time of informed consent until time of interim analysis. The median time on follow-up (or mean time participants were followed) was 168.0, 168.0, and 166.0 days for arms DB: Atogepant, DB: Topiramate, and OL: Atogepant, respectively.
19.8%
54/273 • Number of events 59 • All-cause mortality and adverse event tables include events reported from the time of informed consent until time of interim analysis. The median time on follow-up (or mean time participants were followed) was 168.0, 168.0, and 166.0 days for arms DB: Atogepant, DB: Topiramate, and OL: Atogepant, respectively.
2.2%
10/457 • Number of events 11 • All-cause mortality and adverse event tables include events reported from the time of informed consent until time of interim analysis. The median time on follow-up (or mean time participants were followed) was 168.0, 168.0, and 166.0 days for arms DB: Atogepant, DB: Topiramate, and OL: Atogepant, respectively.
General disorders
FATIGUE
14.0%
38/272 • Number of events 42 • All-cause mortality and adverse event tables include events reported from the time of informed consent until time of interim analysis. The median time on follow-up (or mean time participants were followed) was 168.0, 168.0, and 166.0 days for arms DB: Atogepant, DB: Topiramate, and OL: Atogepant, respectively.
15.4%
42/273 • Number of events 46 • All-cause mortality and adverse event tables include events reported from the time of informed consent until time of interim analysis. The median time on follow-up (or mean time participants were followed) was 168.0, 168.0, and 166.0 days for arms DB: Atogepant, DB: Topiramate, and OL: Atogepant, respectively.
1.1%
5/457 • Number of events 5 • All-cause mortality and adverse event tables include events reported from the time of informed consent until time of interim analysis. The median time on follow-up (or mean time participants were followed) was 168.0, 168.0, and 166.0 days for arms DB: Atogepant, DB: Topiramate, and OL: Atogepant, respectively.
Infections and infestations
NASOPHARYNGITIS
13.2%
36/272 • Number of events 43 • All-cause mortality and adverse event tables include events reported from the time of informed consent until time of interim analysis. The median time on follow-up (or mean time participants were followed) was 168.0, 168.0, and 166.0 days for arms DB: Atogepant, DB: Topiramate, and OL: Atogepant, respectively.
11.4%
31/273 • Number of events 37 • All-cause mortality and adverse event tables include events reported from the time of informed consent until time of interim analysis. The median time on follow-up (or mean time participants were followed) was 168.0, 168.0, and 166.0 days for arms DB: Atogepant, DB: Topiramate, and OL: Atogepant, respectively.
4.2%
19/457 • Number of events 22 • All-cause mortality and adverse event tables include events reported from the time of informed consent until time of interim analysis. The median time on follow-up (or mean time participants were followed) was 168.0, 168.0, and 166.0 days for arms DB: Atogepant, DB: Topiramate, and OL: Atogepant, respectively.
Metabolism and nutrition disorders
DECREASED APPETITE
9.9%
27/272 • Number of events 27 • All-cause mortality and adverse event tables include events reported from the time of informed consent until time of interim analysis. The median time on follow-up (or mean time participants were followed) was 168.0, 168.0, and 166.0 days for arms DB: Atogepant, DB: Topiramate, and OL: Atogepant, respectively.
12.5%
34/273 • Number of events 37 • All-cause mortality and adverse event tables include events reported from the time of informed consent until time of interim analysis. The median time on follow-up (or mean time participants were followed) was 168.0, 168.0, and 166.0 days for arms DB: Atogepant, DB: Topiramate, and OL: Atogepant, respectively.
1.5%
7/457 • Number of events 7 • All-cause mortality and adverse event tables include events reported from the time of informed consent until time of interim analysis. The median time on follow-up (or mean time participants were followed) was 168.0, 168.0, and 166.0 days for arms DB: Atogepant, DB: Topiramate, and OL: Atogepant, respectively.
Nervous system disorders
DISTURBANCE IN ATTENTION
9.6%
26/272 • Number of events 26 • All-cause mortality and adverse event tables include events reported from the time of informed consent until time of interim analysis. The median time on follow-up (or mean time participants were followed) was 168.0, 168.0, and 166.0 days for arms DB: Atogepant, DB: Topiramate, and OL: Atogepant, respectively.
7.0%
19/273 • Number of events 22 • All-cause mortality and adverse event tables include events reported from the time of informed consent until time of interim analysis. The median time on follow-up (or mean time participants were followed) was 168.0, 168.0, and 166.0 days for arms DB: Atogepant, DB: Topiramate, and OL: Atogepant, respectively.
0.22%
1/457 • Number of events 1 • All-cause mortality and adverse event tables include events reported from the time of informed consent until time of interim analysis. The median time on follow-up (or mean time participants were followed) was 168.0, 168.0, and 166.0 days for arms DB: Atogepant, DB: Topiramate, and OL: Atogepant, respectively.
Nervous system disorders
DIZZINESS
10.3%
28/272 • Number of events 29 • All-cause mortality and adverse event tables include events reported from the time of informed consent until time of interim analysis. The median time on follow-up (or mean time participants were followed) was 168.0, 168.0, and 166.0 days for arms DB: Atogepant, DB: Topiramate, and OL: Atogepant, respectively.
7.7%
21/273 • Number of events 25 • All-cause mortality and adverse event tables include events reported from the time of informed consent until time of interim analysis. The median time on follow-up (or mean time participants were followed) was 168.0, 168.0, and 166.0 days for arms DB: Atogepant, DB: Topiramate, and OL: Atogepant, respectively.
0.88%
4/457 • Number of events 4 • All-cause mortality and adverse event tables include events reported from the time of informed consent until time of interim analysis. The median time on follow-up (or mean time participants were followed) was 168.0, 168.0, and 166.0 days for arms DB: Atogepant, DB: Topiramate, and OL: Atogepant, respectively.
Nervous system disorders
HYPOAESTHESIA
5.5%
15/272 • Number of events 17 • All-cause mortality and adverse event tables include events reported from the time of informed consent until time of interim analysis. The median time on follow-up (or mean time participants were followed) was 168.0, 168.0, and 166.0 days for arms DB: Atogepant, DB: Topiramate, and OL: Atogepant, respectively.
0.73%
2/273 • Number of events 2 • All-cause mortality and adverse event tables include events reported from the time of informed consent until time of interim analysis. The median time on follow-up (or mean time participants were followed) was 168.0, 168.0, and 166.0 days for arms DB: Atogepant, DB: Topiramate, and OL: Atogepant, respectively.
0.00%
0/457 • All-cause mortality and adverse event tables include events reported from the time of informed consent until time of interim analysis. The median time on follow-up (or mean time participants were followed) was 168.0, 168.0, and 166.0 days for arms DB: Atogepant, DB: Topiramate, and OL: Atogepant, respectively.
Nervous system disorders
PARAESTHESIA
40.4%
110/272 • Number of events 129 • All-cause mortality and adverse event tables include events reported from the time of informed consent until time of interim analysis. The median time on follow-up (or mean time participants were followed) was 168.0, 168.0, and 166.0 days for arms DB: Atogepant, DB: Topiramate, and OL: Atogepant, respectively.
5.1%
14/273 • Number of events 16 • All-cause mortality and adverse event tables include events reported from the time of informed consent until time of interim analysis. The median time on follow-up (or mean time participants were followed) was 168.0, 168.0, and 166.0 days for arms DB: Atogepant, DB: Topiramate, and OL: Atogepant, respectively.
0.22%
1/457 • Number of events 1 • All-cause mortality and adverse event tables include events reported from the time of informed consent until time of interim analysis. The median time on follow-up (or mean time participants were followed) was 168.0, 168.0, and 166.0 days for arms DB: Atogepant, DB: Topiramate, and OL: Atogepant, respectively.

Additional Information

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