On June 27, at the 12th Congress of the European Academy of Neurology (EAN) 2026, three e-posters with results from the Phase III ECLIPSE trial (NCT06241313) of AbbVie’s Aquipta (atogepant) were presented. ECLIPSE was a randomised, double-blind, placebo-controlled, Phase III trial evaluating Aquipta as an acute treatment for patients who experience two to eight moderate-to-severe migraine attacks per month in each of the three months prior to screening. The trial was conducted across Europe and Asia, and was the basis for the European approval of Aquipta for acute treatment of migraine in June 2026. In August 2023, Aquipta was approved in Europe for the preventive treatment of migraine in adults who have four or more migraine days per month.
The first poster focused on the consistency of atogepant’s effectiveness in acute migraine treatment across multiple attacks. The trial demonstrated that atogepant was able to demonstrate within-participant consistency of effect defined by achieving secondary endpoints in two or more out of three attacks treated with the drug during the double-blind period of the trial. These secondary endpoints included pain freedom and pain relief at two hours, sustained pain freedom and pain relief from 2–24 hours, and sustained pain freedom and pain relief from 2–48 hours. Across four migraine attacks, a higher proportion of participants receiving atogepant achieved pain freedom at 2 hours (24.3–32.7%) compared with placebo (5.7–13.1%), with the same trend seen at the other endpoints.
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The second poster focused on atogepant’s efficacy at reducing migraine symptoms and rescue medication use. The results demonstrated that the proportion of patients free from their most bothersome symptom (MBS) at two hours post dose was high for patients who received atogepant (43.2–46.9%) compared with those who received placebo (22.3–32.7%). Additionally, a higher proportion of patients treated with atogepant saw an absence of photophobia at two hours, an absence of phonophobia at two hours, and an absence of nausea at two hours compared with patients who received placebo. Across all treated migraine attacks, the proportion of patients who used rescue medication within 24 and 48 hours after dosing was also lower in patients who took atogepant compared with placebo.
The third poster focused on atogepant’s effect on cognitive function following acute treatment across multiple attacks. A higher proportion of patients treated with atogepant rated “not difficult at all” in ability to think clearly on the Cognitive Function Scale at two hours post-dosing compared with patients who received placebo. Additionally, the responder rates for the ability to think clearly over time increased at four hours and eight hours post-dose for patients treated with atogepant, whereas they decreased for patients who received placebo after attack 1, with a similar trend seen for attacks 3 and 4.
Currently, the first-line acute treatments for migraine are triptans, which can also be used in combination with non-steroidal anti-inflammatory drugs. However, not all patients will respond to triptans, and they are also contraindicated in patients who suffer from or are at risk of cardiovascular problems. The approval of Aquipta, which does not carry cardiovascular risk, for acute migraine will provide an alternative acute treatment option for patients. However, it is highly unlikely that Aquipta could become a first-line therapy for acute migraine treatment, given that it is significantly more expensive than triptans, which are largely available off-patent as generics. Key opinion leaders (KOLs) previously interviewed by GlobalData have noted that the gepants had similar efficacy to the triptans. As such, favorable patient opinions of gepants could increase their prescription if it means that patients are more likely to persist with taking the drug, therefore getting the maximum treatment benefit and enabling more effective disease management. While Eli Lilly’s Reyvow (lasmiditan) will provide some competition as an alternative acute treatment, Aquipta’s main competition will come from Pfizer’s Vydura (rimegepant), which was approved as both an acute and preventive therapy in Europe in 2022. As such, the results presented at EAN highlighting Aquipta’s ability to improve cognitive function will stand out to patients as a particular benefit of taking Aquipta, potentially differentiating it from Vydura.
