Seven-day CGRP regimen may fill the menstrual migraine prevention gap

Clinical takeaway: For patients with disabling migraine attacks that recur predictably around menses, document their timing, burden, and acute medication use. A seven-day course of atogepant could eventually offer targeted prevention without continuous treatment, but this cycle-timed regimen is not yet approved.

Menstrual migraine attacks are often more severe, longer lasting, and harder to treat than other attacks. No medication is currently approved specifically for this migraine pattern, leaving clinicians to adapt acute therapies or general preventive strategies.

Atogepant is already approved as a once-daily preventive treatment for episodic and chronic migraine in adults, but not specifically for menstrual migraine or for seven-day dosing around menses. Phase 3 LUNA results suggest this oral CGRP therapy may also work as cycle-timed prevention.

The 468 participants took atogepant for seven consecutive days, beginning three days before expected menses. Across three cycles, migraine days during the perimenstrual period decreased by 1.20 days with atogepant versus 0.40 days with placebo.

Atogepant also improved all eight ranked secondary endpoints, spanning headache burden, acute medication use, function, cognition, and responder outcomes. Safety findings were consistent with the drug’s known profile, with no new signals reported.

Because menstrual attacks can be prolonged, disabling, and less responsive to medication, reducing this predictable burden could mean fewer days of impaired function and less reliance on acute therapy.

If approved, the regimen could prompt clinicians to identify menstrual patterns more routinely instead of treating each attack in isolation. It may be especially useful when attacks cluster around menses but continuous prevention is otherwise unnecessary. Reliable cycle tracking would be important for timing treatment.

AbbVie plans regulatory submissions worldwide and presentation of the full results at future medical congresses.

“Menstrual migraine attacks are generally more severe and more difficult to treat, making timely intervention particularly important,” said Cristina Tassorelli, MD, PhD, professor of neurology and director of the Headache Science Centre at IRCCS Mondino Foundation, University of Pavia. “LUNA is the first study of a CGRP-targeted treatment to report positive results specifically in menstrual migraine and meets an important unmet need for women.”

Source: AbbVie. (2026 Sep 10). AbbVie extends migraine leadership with positive phase 3 atogepant results in menstrual migraine