OBJECTIVES: The safety and efficacy of ubrogepant have been demonstrated in phase 3 ACHIEVE trials; however, effectiveness of ubrogepant in the real-world setting has yet to be fully characterized. This study aims to examine real-world effectiveness of ubrogepant for the acute treatment of migraine in patients who switched to ubrogepant due to the lack of efficacy of their prior acute treatment.

METHODS: The UNIVERSE (Ubrogepant users’ experience: Patients on ubrogepant, characteristics and outcomes) study is an observational cross-sectional study of US adult users of the Migraine Buddy application who self-reported using ubrogepant for ≥4 prior migraine headaches, including ≥1 dose in the preceding 14 days. Eligible participants completed a 29-question survey assessing patient characteristics, treatment patterns, outcomes, and satisfaction with ubrogepant.

RESULTS: Of 302 respondents, 87.4% (n=264) switched to ubrogepant due to their prior treatment’s lack of efficacy. For this subgroup, mean age was 42 years, 89% were female, 35.6% had chronic migraine, and 55.9% previously tried ≥3 triptans. Most reported being satisfied with ubrogepant for achieving pain relief at 2-hours (76.1%), 4-hours (83.3%), and 24-hours (78.4%) post-dose. A large proportion reported satisfaction with the ability to think clearly (85.2%) and with their return to normal function (84.8%) after ubrogepant treatment. Most (91.7%) reported they were likely to continue ubrogepant use. Analysis of prior and concurrent acute medication revealed reduced use of opioids (-28%), barbiturates (-25%), ergots (-15%), triptans (-55%), nonsteroidal anti-inflammatory drugs (-38%), and other acute medication classes (-37%).

CONCLUSIONS: Among patients who self-reported lack of efficacy as the reason for prior treatment failure, ubrogepant use was associated with high satisfaction for achieving pain relief, ability to think clearly, and return to normal function. Most indicated they were likely to continue its use. Ubrogepant was associated with reductions in opioid and barbiturate use, suggesting additional clinical benefits for users.