Actively Recruiting
Comparative Effectiveness of Migraine Preventive Medications: The APT Comparison Study
Led by Mayo Clinic · Updated on 2026-04-03
1335
Participants Needed
23
Research Sites
229 weeks
Total Duration
On this page
Sponsors
M
Mayo Clinic
Lead Sponsor
U
University of Iowa
Collaborating Sponsor
AI-Summary
What this Trial Is About
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.
CONDITIONS
Official Title
Comparative Effectiveness of Migraine Preventive Medications: The APT Comparison Study
Who Can Participate
Eligibility Criteria
You may qualify if you...
- Adults aged 18 to 70 years at enrollment
- Diagnosis of migraine with aura, migraine without aura, and/or chronic migraine according to ICHD-3 criteria
- Migraine started before age 50
- Migraine present for at least 12 months
- At least four moderate to severe headache days per month confirmed by a four-week headache diary
- If already on migraine preventive treatment, willing to keep the dose unchanged for the first 16 weeks
- Not pregnant or breastfeeding
- Women of childbearing potential must agree to use effective contraception
- Willing and able to provide informed consent
- Willing and able to complete all research visits
You will not qualify if you...
- Allergies or contraindications to atogepant, propranolol, or topiramate
- Currently or previously taking atogepant, propranolol, or topiramate
- Unwilling to take any of the study medications
- Currently using CGRP-targeting preventive medication or beta-blockers
- Having migraine with brainstem aura, hemiplegic migraine, retinal migraine, aura without headache only, pure menstrual migraine, trigeminal autonomic cephalalgias, or facial neuralgias
- Secondary headache disorders except medication overuse headache
- Migraine preventive treatment started or dose changed within 12 weeks before enrollment
- Using opioids or butalbital five or more days per month on average for at least 3 months prior
- Current or past epilepsy
- Severe liver impairment
- Moderate or severe kidney impairment
- Occasional as-needed propranolol use for anxiety is allowed
AI-Screening
AI-Powered Screening
Complete this quick 3-step screening to check your eligibility
Trial Site Locations
Total: 23 locations
1
Northern Arizona Healthcare
Flagstaff, Arizona, United States, 86001
Actively Recruiting
2
Mayo Clinic Arizona
Phoenix, Arizona, United States, 85054
Actively Recruiting
3
USC Keck
Los Angeles, California, United States, 90033
Not Yet Recruiting
4
Clinical Research Institute
Los Angeles, California, United States, 90048
Actively Recruiting
5
Desert Physicians Medical Group
Palm Springs, California, United States, 92262
Actively Recruiting
6
The Neurology Group
Pomona, California, United States, 91767
Actively Recruiting
7
University of Colorado Anschutz Medical Campus
Aurora, Colorado, United States, 80045
Actively Recruiting
8
Mayo Clinic Florida
Jacksonville, Florida, United States, 32066
Actively Recruiting
9
Apple Med Research
Miami, Florida, United States, 33126
Actively Recruiting
10
Clinical Trials of New England
Hyde Park, Massachusetts, United States, 02136
Actively Recruiting
11
Mayo Clinic
Rochester, Minnesota, United States, 55905
Actively Recruiting
12
Washington University St Louis
St Louis, Missouri, United States, 63110
Actively Recruiting
13
Advanced Research Institute Reno
Reno, Nevada, United States, 89511
Actively Recruiting
14
JFK Neuroscience Institute
Edison, New Jersey, United States, 08820
Actively Recruiting
15
Nuvance Health Institute
Kingston, New York, United States, 12401
Actively Recruiting
16
Wake Forest University Health
Winston-Salem, North Carolina, United States, 27157
Actively Recruiting
17
Ohio State University Wexner Medical Center
Columbus, Ohio, United States, 43210
Not Yet Recruiting
18
Advanced Research Institute
Portland, Oregon, United States, 97223
Actively Recruiting
19
University of Pennsylvania
Philadelphia, Pennsylvania, United States, 19107
Actively Recruiting
20
Vanderbilt Medical Center
Nashville, Tennessee, United States, 37215
Actively Recruiting
21
DHR Health Headache Center
McAllen, Texas, United States, 78504
Not Yet Recruiting
22
Advanced Research Institute Ogden
Ogden, Utah, United States, 84405
Actively Recruiting
23
West Virginia University
Morgantown, West Virginia, United States, 26506
Actively Recruiting
Research Team
M
Michael R Leonard, MDiv
CONTACT
D
Dani C Smith, M.S.
CONTACT
How is the study designed?
Study Type
INTERVENTIONAL
Masking
NONE
Allocation
RANDOMIZED
Model
PARALLEL
Primary Purpose
TREATMENT
Number of Arms
3
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