Comparative Effectiveness of Migraine Preventive Medications: The APT Comparison Study
Eligible age
18–70 yrs
Accepts
All genders
Locations
21 states
Healthy volunteers
No
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About this study
This goal of this study is to compare three medications used for migraine preventive treatment. This study will compare atogepant, a newer migraine preventive medication, with two older preventive medications, topiramate and propranolol. It will be determined if one works better and is more tolerable than the others. Research participants will: * Be randomly assigned to one of the three medications. * Provide information about their migraine pattern using a daily headache diary and during research visits.
Sponsor: Mayo Clinic
You may qualify if…
- ✓ Adults, 18-70 years of age at the time of enrollment
- ✓ Migraine with aura, migraine without aura, and/or chronic migraine; according to ICHD-3 diagnostic criteria. (Those with daily or continuous headaches are not excluded.)
- ✓ Migraine onset prior to 50 years of age
- ✓ Migraine present for at least 12 months at the time of enrollment
- ✓ At least four "moderate to severe headache days" per month (by patient self-report and then confirmed during four-week pre-randomization headache diary phase) A "moderate to severe headache day" is defined as a day during which there is a headache of moderate to severe intensity that lasts for at least four hours, or a day on which a migraine-specific acute medication is taken to treat headache.
- ✓ If already taking a migraine preventive treatment, willing to continue with that treatment without dose change during the first 16 weeks of the study, including the 4-week run-in phase and 12-week randomized phase.
- ✓ Not pregnant or breastfeeding
- ✓ Women of childbearing potential must agree to use effective methods of contraception to reduce the risk of pregnancy.
You may not qualify if…
- ✕ Contraindications to taking atogepant, propranolol, or topiramate.
- ✕ Currently taking atogepant, propranolol, or topiramate\*
- ✕ Previously took atogepant, propranolol, or topiramate\*
- ✕ Unwillingness to take atogepant, topiramate, or propranolol.
- ✕ Current use of a CGRP-targeting preventive medication or beta-blocker
- ✕ Migraine with brainstem aura
- ✕ Hemiplegic migraine
- ✕ Retinal migraine
Where it's recruiting
Flagstaff · Phoenix
Los Angeles · Palm Springs · Pomona
Aurora
Hollywood · Jacksonville · Miami
Hyde Park
Rochester
St Louis
Omaha
Reno
Edison
Kingston · Manhasset · New York
Charlotte · Salisbury · Winston-Salem
Source: ClinicalTrials.gov · NCT06972056 · last updated 2026-06-16