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EpilepsyAugust 2021Summary reviewed June 2026

What the ADVANCE Trial Found — Atogepant for Migraine Prevention

Researchers tested atogepant, a daily pill that blocks a protein linked to migraines. People taking 60 mg had about 4 fewer migraine days per month compared to 2.5 fewer days with a sugar pill. Side effects included constipation and nausea.

What the trial was testing

The ADVANCE enrolled 910 patients with epilepsy. The study was sponsored by Allergan and tracked outcomes across the full group of patients who matched the trial's eligibility profile.

It was a large trial designed to confirm whether the treatment works well enough for wider use. Trials at this stage are designed to produce evidence regulators and physicians can act on — not just observations to follow up later.

What the results showed

People taking atogepant had 1.7 more fewer migraine days per month than those on a sugar pill.

The New England journal of medicine · 2021 · NCT03777059

These findings — that people taking the highest dose had about 4 fewer migraine days each month — were published in the The New England journal of medicine and represent the headline result of the study.

Researchers tracked outcomes across 910 patients enrolled in the trial. The result was consistent enough across the group that the team felt confident reporting it.

What this means for patients

For patients with epilepsy, this result changes the calculus on what to ask their care team about. Whether it changes day-to-day care depends on factors like disease subtype, prior treatments, and where the patient is in their care journey.

What you can do now

Atogepant is FDA-approved for preventing migraines and is available by prescription under the brand name Qulipta. If you have frequent migraines, talk to your doctor about whether this daily pill might help reduce how often you get them.

Eligibility for the treatments mentioned above depends on specific test results and clinical history. Bring this summary, the trial name, and your most recent labs or pathology report to your next visit.