News in brief: Atogepant to seek approval for chronic migraine; Dopaminergic medication key to gait problems in PD; Shingrix now available for over 18s

15 Mar 2022

Atogepant to seek approval for chronic migraine

The CGRP antagonist atogepant has shown acceptable efficacy and safety in a phase 3 trial in adult patients with chronic migraine, according to manufacturer AbbVie.

The PROGRESS study involving 778 patients with chronic migraine showed that 12 weeks of treatment resulted in a statistically significant reduction from baseline in mean monthly migraine days compared to placebo, the company announced.

Based on modified intention to treat population,  patients in the atogepant 60 mg QD and 30 mg BID treatment arms of the study showed a decrease of 6.88 and 7.46 monthly migraine days, respectively, compared to patients in the placebo arm, who experienced a decrease of 5.05 monthly migraine days.

Atogepant also improved the secondary endpoint of the proportion of patients that achieved at least a 50% reduction in mean monthly migraine days across the 12-week treatment period, compared to placebo

The safety profile of the drug was consistent with safety findings observed in previous studies in an episodic migraine population, the company said, adding that it would be seeking approval for its use as a preventive treatment of chronic migraine globally.

Dopaminergic medication key to gait problems in PD

Optimisation of the dopaminergic medication regimen can help improve mobility and gait problems in patients with advanced Parkinson disease (PD), European research has shown.

A pilot study involving 14 patients with advanced PD found a larger positive additional influence of dopaminergic medication than of deep brain stimulation in the subthalamic nucleus (DBS) on temporal gait parameters.

The effect on dual tasking conditions was particular relevant for real world mobility problems in people with advanced PD, said the authors of the paper from the Department of Neurology, Medical University of Vienna, Austria.

In their study, dopaminergic medication improved multiple parameters of such as gait speed, cadence and number of step  under dual tasking walking conditions and the effect was larger than the effect of deep brain stimulation.

“If these, mostly advanced, PD patients suffer from gait impairments and problems performing dual tasks, the optimization of the dopaminergic medication regimen is a very important component of therapy,” the authors concluded in Neuromodulation.

Shingrix now available for over 18s

The non-live recombinant Varicella Zoster Virus vaccine Shingrix is now available on the private market for the prevention of shingles (herpes zoster) and post-herpetic neuralgia (PHN) in people aged 18 years who are at increased risk of shingles.

In June 2021 Shingrix was made available to people over the age of 50. According to GSK, the new approval of Shingrix was supported by a range of clinical trials in highly immunocompromised populations aged 18 years and older, including patients with solid tumours, haematological malignancies, HIV infection, autologous hematopoietic stem cell transplant recipients, and renal transplant patients on chronic immunosuppressive treatment.

The TGA has previously warned of the risks of live zoster vaccines in immunocompromised people after receiving reports of two deaths, The most recent case involved a man with arthritis who at the time of vaccination was taking hydroxychloroquine and a low dose of prednisolone, who died 3 weeks after receiving Zostavax.

Shingrix is given intramuscularly in two doses, six months apart.

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