Migraine Drug Ubrogepant Tackles Debilitating Early Symptoms
The drug — called ubrogepant — is already known to stop the onset of a full-blown migraine attack in some people if they take it when the headache begins. But a phase III clinical trial, described in Nature Medicine on 12 May, shows that it can also tackle the 'prodrome' symptoms that arrive hours or even days earlier.
The results suggest that ubrogepant could 'free patients from a disabling part of migraine,' says study co-author Peter Goadsby, a neuroscientist at King's College London.
On supporting science journalism
If you're enjoying this article, consider supporting our award-winning journalism by subscribing. By purchasing a subscription you are helping to ensure the future of impactful stories about the discoveries and ideas shaping our world today.
Early intervention
The process of a migraine starts long before the head pain, when brain circuits involving the hypothalamus — a region that regulates several vital bodily functions — become dysregulated. In the prodrome, or premonitory phase, people can experience various unpleasant symptoms, including fatigue, neck pain, an aversion to light (photophobia) or sound (phonophobia) and difficulty concentrating.
'Not enough attention has been given to prodrome symptoms,' says Goadsby. The trial aimed to 'fill this gap' by investigating whether ubrogepant has an effect on the initial stages of a migraine.
The trial included 438 participants who could reliably identify incoming migraine attacks from their prodromal symptoms. During the 60 days of the trial, they took ubrogepant or a placebo whenever they felt any prodromal symptoms coming on, and reported whether doing this had any effect.
The results suggest that for some participants, the drug increased their ability to concentrate one hour after treatment, reduced their photophobia two hours after treatment and reduced their fatigue and neck pain after three hours.
But the 'effect sizes were small' and never more than 15 percentage points compared with the placebo, points out Gregory Dussor, a neuroscientist and migraine specialist at the University of Texas at Dallas. For example, 27% of participants who took ubrogepant reported an absence of fatigue, compared with 17% who took the placebo. Dussor suggests this modest improvement is because the class of drugs to which ubrogepant belongs is a 'life-changing therapeutic' for a minority of people — perhaps only one in five, according to some studies. It makes little difference to others, so its effect for that minority 'gets diluted in the data'.
'Nevertheless, this study answers the question of whether ubrogepant works when you dose it early in the migraine, when people feel prodromal symptoms coming on,' he says.
Know your migraine
Ubrogepant is already known to stop migraine headaches, but Goadsby says the data show that it works substantially better if taken in the prodromal stage rather than once the attack starts. In the trial, it was crucial that participants could predict their preliminary symptoms. 'People who know their migraine would benefit more from this medicine,' he says. The next challenge for the field, he adds, is to train people to understand their migraine symptoms so they can judge when to take ubrogepant.
Dussor thinks that once the prodrome has begun, it is probably still too late for ubrogepant to block the migraine entirely. He says research should explore another question: 'Is there some way to alert people much earlier to take the drug, before they feel symptoms coming on?'
The study could also provide clues about the cause of prodromal symptoms. Ubrogepant works by blocking receptors that bind to calcitonin gene-related peptide (CGRP), a molecule that sensitizes the nerves in the head and skull during a migraine attack. 'Knowing there's some CGRP component earlier than the headache phase is important to know in our mechanistic understanding of migraine,' says Dussor.
Hashtags
Try Our AI Features
Explore what Daily8 AI can do for you:
Comments
No comments yet...
Related Articles
Newsweek
2 hours ago
- Newsweek
Toothpaste Made From Your Own Hair May Repair Your Teeth
Based on facts, either observed and verified firsthand by the reporter, or reported and verified from knowledgeable sources. Newsweek AI is in beta. Translations may contain inaccuracies—please refer to the original content. A new study from King's College London suggests that keratin—the protein found in human hair, skin and wool—can regenerate tooth enamel and potentially halt early tooth decay. Published in Advanced Healthcare Materials, the research found that keratin—when extracted from wool and applied to teeth—forms a crystal-like layer that mimics and rebuilds lost enamel. The study presents keratin as an eco-friendly, biomimetic alternative to traditional fluoride treatments, which can only slow decay, but not reverse it. "Enamel is the hardest tissue in the body, but unlike bone or skin, it cannot repair itself once damaged," Dr. Sherif Elsharkawy, senior author and prosthodontics consultant at King's College London, told Newsweek in an email. "Dentistry has relied for decades on synthetic materials such as plastic resins or ceramics, but these are never a perfect biological match. "I wanted to find a natural, sustainable material that could actually regenerate enamel rather than simply cover damage." Stock image: Woman pointing at her teeth. Stock image: Woman pointing at her teeth. Photo by Fizkes / Getty Images Why It Matters Tooth enamel erosion is irreversible and widespread, and it can be caused by a combination of factors. Acidic foods and drinks—such as soda, citrus and vinegar—erode enamel by lowering the pH in the mouth, which dissolves the minerals that keep teeth hard. Poor oral hygiene allows plaque bacteria to produce acids that contribute to decay, while aggressive brushing can physically wear away the enamel surface. Age also plays a role, as enamel naturally thins over time, exposing the softer dentin underneath. Conditions like acid reflux, dry mouth and eating disorders can accelerate enamel loss as well by increasing acid exposure or reducing saliva, which normally helps neutralize harmful acids. Once tooth enamel is lost, the tooth nerves are exposed, which is painful and makes the teeth sensitive. While fluoride toothpastes are standard for managing this issue, keratin offers a regenerative approach that goes beyond symptom control. What to Know Researchers used wool as a keratin source and applied it to teeth in a laboratory. "Keratin has a molecular structure that can guide minerals into forming enamel-like crystals," Elsharkawy told Newsweek. "Turning waste materials, mainly sheep wool, into a tooth-repair material felt both scientifically exciting and environmentally meaningful." The treatment is versatile, according to Elsharkawy. "Keratin can be transformed into a material as strong and functional as natural enamel," he explained. "It could be delivered through something as simple as toothpaste or as a professional in-clinic gel, making tooth-decay repair accessible, affordable, and sustainable worldwide." What People Are Saying "We knew keratin had promise, but I was impressed by how precisely it guided crystal growth into enamel-like structures," Elsharkawy said. "It did not just coat the tooth—it recreated the highly ordered crystal pattern of natural enamel, something that normally only happens during tooth development." What's Next The team is working on commercial pathways for the treatment, with Elsharkawy noting, "The response has been enormous from dentists, industry, and the public." He added that the group had launched the company Eterna Regeneratives to lead the translation of this breakthrough. "The dental industry already sees this as a game-changing innovation," he explained. "Our first go-to-market products will be toothpaste and mouthwash for daily use, followed by a more potent professional treatment for those at higher risk of decay. [...] "We are confident this will be available to the public within two years."
Time Business News
14 hours ago
- Time Business News
D-Dimer Test Flags Clot Risk, Aids Broader Diagnosis
D Dimer Test is a kind of blood test detecting the presence of D-dimer in the blood. D-dimer is a protein fragment of fibrin formed after Fibrinolysis degradation of blood clot. It is helpful to diagnose the conditions with abnormal blood clots formation and breakdown, intravascular fibrinolysis, and coagulation. High D-dimer levels indicate clinical suspicion of a blood clot and needs ultrasound, CT angiography, scans could be performed to confirm the presence of clot and location of clot. D-Dimer test is not specific to any disease. D-Dimer test is not specific to any disease and thus is performed in conjunction with other evaluations and diagnostic tests. 0.5 is measured as normal range for D-dimer and greater than 0.5 is measured to be positive. D-dimer decreases under abnormal medical case which is measured by specific antibodies. Key Growth Drivers and Opportunities Demand for D-Dimer Testing: Traditional testing is replaced by D-dimer testing, allowing for faster test results, quicker diagnosis, shorter patient wait times, and better patient outcomes overall. D-Dimer testing to be more widely used by customers offering compelling advantages. Moreover, the growing prevalence of lung and cardiovascular illnesses might, in extreme circumstances, lead to potentially fatal blood clot problems, which propels D-Dimer Test. Rising Genetic Disorders: Increasing cases of Thrombus embolism along with various cardiovascular and pulmonary diseases that could be life threating due to clot formation increases the demand for D-Dimer Test globally. D-dimer functions as valuable marker in various clinical conditions such as HIV, atrial fibrillation, coronary artery disease. New technological advancement such as development of aptamers, reducing use of antibodies for D-dimer testing being cost-effective, long-lasting boosts D-Dimer Test widening scope for these tests. Challenges The major challenge consists of inadequate skilled professionals and trained professionals unable to perform the test properly and lack of knowledge leads to false results and restrains the D-Dimer test Market. High cost and poor reimbursement policies restrains people to take such tests for proper diagnosis increasing the prevalence of disease and deaths. Innovation and Expansion Study Links Long COVID Brain Fog to Blood Microclots In September 2023, Finding was published in Nature Medicine, suggesting links between brain fog in long COVID and 'micro clots' in the blood. These clots often contain misfolded fibrinogen proteins that prevent the clots from breaking down, and this effect can clog blood vessels and block oxygen flow to the brain and other organs. Blood tests for both D-dimer and fibrinogen are already standard around the world, so researchers had plenty of available data to check whether the same phenomenon occurred in other groups of patients. LumiraDx Expands Rapid Testing for VTE and Heart Failure In June 2022, LumiraDx Limited, a next-generation point of care Diagnostics Company, announced its cardiovascular offering with a CE Mark for its new NT-proBNP test to aid in the diagnosis of CHF and an updated CE Mark for its D-Dimer test to now rule out venous thromboembolism (VTE) in symptomatic patients. With these two additions, the LumiraDx Platform can further support clinicians in quickly and accurately assessing patient symptoms for both VTE and heart failure at the point of care. The LumiraDx NT-proBNP test is a rapid microfluidic immunofluorescence assay for the quantitative measurement of NT-proBNP in human capillary, venous whole blood and plasma specimens. Inventive Sparks, Expanding Markets The major companies present in the D-dimer test market are Bio/Data Corporation, Becton Dickinson BV, Sysmex Corporation, Abbott Laboratories, Inc., Dickinson and Company, Hoffman-La Roche Ltd., among others. Global companies work to foster lasting innovation, grow their markets, and provide quality goods and services. They concentrate on improving customer experience, applying tech, and creating strong operations. About Author: Prophecy is a specialized market research, analytics, marketing and business strategy, and solutions company that offer strategic and tactical support to clients for making well-informed business decisions and to identify and achieve high value opportunities in the target business area. Also, we help our client to address business challenges and provide best possible solutions to overcome them and transform their business. TIME BUSINESS NEWS
Axios
a day ago
- Axios
Off-the-shelf vaccine shows success against deadly cancers
An experimental vaccine targeting one of the most common genetic drivers of hard-to-treat pancreatic and colorectal cancers prevented their recurrence, raising hopes for an "off the shelf" treatment that can train the immune system to attack malignancies. Why it matters: If shown effective in further trials, the vaccine could become a particularly important tool in staving off the return of pancreatic cancer, which sees roughly 80% of surgically removed tumors recur within five years. What they're saying:"This was a trial all of us in the medical oncology world have been waiting for," said Tracy Proverbs-Singh, an oncologist at Hackensack Meridian's John Theurer Cancer Center. "We see these patients for five years, we see the recurrences, we have to re-treat them, and it's devastating. And after we finish chemo, there's not a lot we can do." Go deeper: The peptide vaccine targets the KRAS mutation that occurs in roughly 90% of pancreatic cancers and half of colorectal cancers. Researchers administered the shot, called ELI-002 2P, to 25 patients who'd received conventional treatments but still had small amounts of cancer left in their bodies and were at high risk of relapse. Half of patients had no relapse by 16.3 months, and median overall survival was 28.9 months — both exceeding historical norms, per the study in Nature Medicine. The greatest benefit was seen in patients who had strong T cell responses. At the 20-month mark, 17 of the 25 patients had strong immune responses with 11 of those patients having no recurrence and six having delayed recurrence. The latter successfully underwent further treatment. "All the 17 were still alive which is why we think there's optimistically, something real going on here, because that's much better than what we might have expected historically," said Zev Wainberg, co-director of the UCLA GI Oncology Program and one of the lead authors. Yes, but: Researchers do not yet understand why eight of the 23 patients did not develop a strong immune response as a result of the vaccine. Between the lines: Much of the enthusiasm around therapeutic cancer vaccines has centered on personalized mRNA technology. It is notable that researchers were able to use a non-personalized vaccine because it can be more easily developed at scale. "It's a big shot in the arm for the pancreatic cancer vaccine, which has been elusive in the context of us being able to get something that's effective in the early stages," said Madappa Kundranda, division chief for cancer medicine at Banner MD Anderson Cancer Center. Reality check: This is still a small Phase 1 trial and will require a more robust randomized controlled trial. Wainberg said the team has already completed such a trial and should have results back in 2026. What to watch: Pancreatic cancer, which has a five-year survival rate of around 13% in the U.S., could be treated very differently within the next two years as multiple new drugs targeting the same mutations are also developed.
