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RecruitingMigraine

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

Arizona

Flagstaff · Phoenix

California

Los Angeles · Palm Springs · Pomona

Colorado

Aurora

Florida

Hollywood · Jacksonville · Miami

Massachusetts

Hyde Park

Minnesota

Rochester

Missouri

St Louis

Nevada

Reno

New York

Kingston · Manhasset · New York

North Carolina

Charlotte · Salisbury · Winston-Salem

Source: ClinicalTrials.gov · NCT06972056 · last updated 2026-06-16