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Qualifying prodromal events were defined as attacks with symptoms in which the participant was confident headache would follow within 1\u20136\u2009h. Of 1,087 screened participants, 477 formed the efficacy analysis population. Outcomes were collected across 48\u2009h showing, for example, at 2\u2009h post-dose, absence of photophobia in 19.5% and 12.5% of ubrogepant- and placebo-treated events, respectively (odds ratio (OR)\u2009=\u20091.72 (95% confidence interval (CI)\u2009=\u20091.13\u20132.61)); at 3\u2009h post-dose, absence of fatigue occurred in 27.3% and 16.8% (OR\u2009=\u20091.85 (95% CI\u2009=\u20091.17\u20132.92)) and absence of neck pain in 28.9% and 15.9% (OR\u2009=\u20092.04 (95% CI\u2009=\u20091.25\u20133.32)) of events; at 4\u2009h post-dose, absence of phonophobia in 50.7% and 35.8% (OR\u2009=\u20091.97 (95% CI\u2009=\u20091.38\u20132.80)) of events; and at 24\u2009h post-dose, absence of dizziness in 88.5% and 82.3% (OR\u2009=\u20091.82 (95% CI\u2009=\u20091.00\u20133.30)) of events. At 1\u2009h and 6\u2009h post-dose, respectively, absence of difficulty concentrating occurred in 8.7% and 2.1% (OR\u2009=\u20094.26 (95% CI\u2009=\u20091.17\u201315.54)) and absence of difficulty thinking occurred in 56.9% and 41.8% (OR\u2009=\u20092.05 (95% CI\u2009=\u20091.14\u20133.71)) of events. Treatment with ubrogepant during the prodromal phase may ameliorate common prodromal symptoms, with improvements possibly as early as 1\u2009h post-dose.<\/jats:p>","DOI":"10.1038\/s41591-025-03679-7","type":"journal-article","created":{"date-parts":[[2025,5,12]],"date-time":"2025-05-12T11:02:24Z","timestamp":1747047744000},"page":"2179-2185","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":30,"title":["Ubrogepant for the treatment of migraine prodromal symptoms: an exploratory analysis from the randomized phase 3 PRODROME trial"],"prefix":"10.1038","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3260-5904","authenticated-orcid":false,"given":"Peter J.","family":"Goadsby","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica","family":"Ailani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David W.","family":"Dodick","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amaal J.","family":"Starling","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chengcheng","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yingyi","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sung Yun","family":"Yu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan H.","family":"Smith","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elimor","family":"Brand-Schieber","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joel M.","family":"Trugman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,5,12]]},"reference":[{"key":"3679_CR1","doi-asserted-by":"publisher","first-page":"1204","DOI":"10.1016\/S0140-6736(20)30925-9","volume":"396","author":"GBD 2019 Diseases Injuries Collaborators.","year":"2020","unstructured":"GBD 2019 Diseases Injuries Collaborators. 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J.A. reports support for the present study from AbbVie, personal fees from AbbVie, Aeon, Amgen, Axsome, BioDelivery Sciences International, Biohaven, Eli Lilly, GlaxoSmithKline, Gore, Impel, Linpharma, Lundbeck, Miravo, Neurolief, Pfizer, Satsuma, Teva, Tonix, Dr. Reddy\u2019s, Scilef and Theranica, clinical trial support from Satsuma, Parema and Ipsen, and provision of editorial services to Current Pain and Headache Reports, Medscape, Neurology Live and SELF magazine. D.W.D. reports the following for the past 48\u2009months: consulting for: AbbVie, Allergan, Amgen, Atria, AYYA Biosciences, Biohaven, CapiThera Ltd, Cerecin, Ceruvia Lifesciences LLC, CoolTech, Ctrl M, Eli Lilly, Genentech, GlaxoSmithKline, Impel, Lundbeck, Nocira, Novartis, Perfood, Pfizer, Praxis, Revance, Satsuma, Theranica and WL Gore; honoraria from: Academy for Continued Healthcare Learning, American Academy of Neurology, Amgen (speaking), Biopharm Communications, Cambridge University Press, Canadian Headache Society, CEA Group Holding Company (Clinical Education Alliance LLC), Eli Lilly (speaking), Clinical Care Solutions, CME Outfitters, Curry Rockefeller Group, DeepBench, Global Access Meetings, Headache Cooperative of the Pacific, KLJ Associates, Lundbeck (speaking), Majallin LLC, Medica Communications LLC, Medlogix Communications, MF Med Ed Research, Miller Medical Communications, MJH Lifesciences, Oxford University Press, Pfizer (speaking), Teva (speaking), Vector Psychometric Group, WebMD Health\/Medscape and Wolters Kluwer; nonprofit board membership for: American Brain Foundation, American Migraine Foundation, Arizona Brain Injury Alliance, Atria Health Collaborative, Domestic Violence HOPE Foundation\/Panfila, International Headache Society Global Patient Advocacy Coalition, ONE Neurology and Precon Health Foundation; research support from: American Migraine Foundation, Henry Jackson Foundation, National Institutes of Health, Patient-Centered Outcomes Research Institute, Sperling Foundation and US Department of Defense; stock options, shareholder, board of directors or patents for: Atria Health (options and employee), Aural analytics (options), Axon Therapeutics (options and board), AYYA Biosciences (options), Cephalgia Group (options and board), Ctrl M (options), Epien (options and board), ExSano (options), Healint (options), King-Devick Technologies (options and board), Man and Science, Matterhorn (shares and board), Nocira (options), Ontologics (shares and board), Palion (options), Precon Health (options and board), Second Opinion\/Mobile Health (options) and Theranica (options); patent 17189376.1-1466: vTitle: Onabotulinum Toxin Dosage Regimen for Chronic Migraine Prophylaxis (Nonroyalty bearing); and patent application submitted: Synaquell (Precon Health). A.J.S. received consulting fees from AbbVie, Allergan, Axsome Therapeutics, eNeura, Everyday Health, Lundbeck, Med-IQ, Medscape, Miller Medical, Satsuma, and WebMD. C.L., Y.L., J.H. and E.B.-S. are employees of AbbVie and may hold AbbVie stock. J.M.T. and S.Y.Y. are former employees of AbbVie and may hold AbbVie stock.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}]}}