Cephalagia

Combination therapy shows promise for chronic migraine prevention

December 12, 2025

In the 24-week, real-world SYNERGY study of 101 patients with chronic migraine and ≥3 prior onabotulinumtoxinA cycles, adding atogepant 60 mg daily reduced monthly migraine days by 6.5 (P<.001) and achieved ≥50% reduction in 45% of participants. Patients experienced a reduction of 6 days in acute medication use (p < 0.001), along with a significant improvement in HIT-6 scores (average decrease of 4 points; p < 0.001). No new safety concerns were reported.

Clinical takeaway: For patients with incomplete response to onabotulinumtoxinA alone, consider adding atogepant to enhance migraine prevention and reduce reliance on acute medications.

Source:

Iannone LF, et al. (2025, December 2). Cephalagia. Combination preventive therapy with onabotulinumtoxinA and atogepant for chronic migraine: A 24-week, prospective, real-world evaluation (SYNERGY study). https://pubmed.ncbi.nlm.nih.gov/41329703/