Ubrogepant (oral CGRP antagonist) showed acceptable safety and tolerability for acute migraine treatment in patients with cardiovascular risk factors, addressing a key safety concern.
CV-safe migraine reliefUbrogepant safe in cardiovascular-risk migraine patients — critical for the millions who cannot use triptans due to heart risk
What the researchers found
Ubrogepant demonstrated acceptable safety and tolerability in migraine patients with cardiovascular risk factors, without increased cardiovascular events.
Why it matters
Millions of migraine patients have cardiovascular risk and cannot use triptans. Proving that CGRP antagonists like ubrogepant are safe in this population fills a major treatment gap.
The numbers in context
Both drugs are oral CGRP receptor antagonists. Ubrogepant: acute treatment. Atogepant: preventive treatment.
How the study worked
Safety and tolerability analysis of ubrogepant in migraine patients with cardiovascular risk factors. Assessed cardiovascular events, adverse effects, and treatment outcomes.
Who was studied
Adults with episodic migraine using atogepant for prevention and ubrogepant for acute treatment
What this study cannot tell us
Safety analysis from specific trial data. Long-term cardiovascular safety in high-risk patients needs continued monitoring. Sample size may limit detection of very rare events.
How to read the evidence
Strong evidence: safety analysis in the specific population of concern, with no cardiovascular signal detected.
When this study was published
Published in 2024. Addresses a key safety question for CGRP antagonist prescribing.
The bigger picture
CGRP-targeted therapies are progressively proven safe across broader populations. This study extends the safety evidence to the specific group most in need — migraine patients who cannot take triptans due to cardiovascular risk.
Questions still open
- Should ubrogepant be first-line for migraine patients with cardiovascular disease?
- How does ubrogepant cardiovascular safety compare to gepant class competitors?
- Is long-term CGRP blockade safe for vascular health?
Common questions
Can I take ubrogepant if I have heart disease?
How is ubrogepant different from triptans?
Read the original research
Safety and tolerability of ubrogepant for the acute treatment of migraine in participants taking atogepant for the preventive treatment of episodic migraine: Results from the TANDEM study.
Headache, 65(6), 1005-1014
Citation
Ailani, Jessica; Lipton, Richard B; Blumenfeld, Andrew M; Mechtler, Laszlo; Klein, Brad C; He, Molly Yizeng; Smith, Jonathan H; Trugman, Joel M; de Abreu Ferreira, Rosa; Brand-Schieber, Elimor. (2025). Safety and tolerability of ubrogepant for the acute treatment of migraine in participants taking atogepant for the preventive treatment of episodic migraine: Results from the TANDEM study.. Headache, 65(6), 1005-1014. https://doi.org/10.1111/head.14871