When it comes to preventing chronic migraines, market-dominating injectables from Teva, Eli Lilly and Amgen are starting to feel the heat from formidable oral rivals. Looking to gain an early leg up, pharma companies have tried to pin their antibodies against up-and-coming migraine meds in an effort to woo over patients and doctors.
Except a new analysis from Teva pitting its long-acting injectable Ajovy against oral foes from Biohaven Pharmaceuticals and AbbVie doesn’t appear to separate the drug from the pack as much as the company likely hoped.
In the new data released on Wednesday, Teva looked to see how well Ajovy, Biohaven’s Nurtec ODT and AbbVie’s atogepant reduced migraines, as measured in days per month, when compared with placebo. The analysis is being presented during the International Headache Society and European Headache Federation Joint Congress.
Teva conducted a meta analysis, or a review of Nurtec's, atogepant's and Ajovy's separate clinical trials that compared those meds to a placebo. When pitted against trial data of every-other-day dosing for Nurtec ODT, Teva’s analysis found that the monthly 225 milligram and quarterly 675 milligram Ajovy injections reduced migraine days by 1.3 and 1.02 days more, respectively.
Further, while Ajovy outperformed atogepant slightly across all paired dosing strategies, it didn’t reduce migraine days by more than a day on average.
Overall for the analysis, no statistical significance could be determined, Teva's release said.
Still, Ajovy showed statistically significant benefits in several drug and dosing matchups, lead authors Michael Seminerio and Steve Silberstein said in an emailed statement. Seminerio serves as Teva's U.S. medical lead for migraine and headache, while Silberstein is a professor of neurology and the director of the Jefferson Headache Center at Thomas Jefferson University.
The authors countered that fremanezumab was either numerically different in favor of Ajovy or statistically significantly better than atogepant when comparing change from baseline in MMD.
While it’s unclear whether the analysis will help boost prescriptions, the generic giant believes the comparisons “provide clinicians with new insights into the impact of choosing a treatment option for each individual patient,” Teva’s Matthias Mueller, MD, VP of global medical affairs, said in a release.
Teva's med has lagged rivals from Eli Lilly and Amgen since launching in 2018, but its sales have gained steam lately. Ajovy brought in $70 million in second quarter global revenues, compared with Emgality’s $156 million and Aimovig’s $82 million.
The new analysis comes months after Biohaven's Nurtec ODT scored a potentially market-shifting FDA nod in May to prevent episodic migraines, or fewer than 15 days of headaches per month. It’s now the first and only oral anti-CGRP drug approved as a dual therapy for both acute and preventive use. Hot on its tail, however, is AbbVie’s oral atogepant. That drug is currently awaiting an FDA nod to prevent migraines.
Analysts see Nurtec ODT shaping up to become a “major migraine player.” Biohaven reported in early July that Nurtec ODT, also known as rimegepant, raked in $93 million in sales during the second quarter, a whopping 112% increase compared with the previous quarter.
Teva isn’t the only company trying to tamp down Nurtec’s advances. Lilly plans to launch its own head-to-head study pitting its monthly injectable monoclonal antibody Emgality against Nurtec ODT in patients with episodic migraines this year.
Editor's note: This story was updated with a statement from study authors Michael Seminerio and Steve Silberstein.