Comparing atogepant, topiramate and propranolol for preventing migraine
Compares atogepant, topiramate and propranolol for migraine prevention in adults.
Plain-language title generated from the registry record
Registry title: Comparative Effectiveness of Migraine Preventive Medications: The APT Comparison Study
Key facts
- Where
- Aurora, Charlotte, Columbus, Edison, Flagstaff, Hazel Green, Hollywood, Hyde Park, Jacksonville, Kingston, Los Angeles, Manhasset, Marshfield, McAllen, Miami, Milwaukee, Morgantown, Nashville, New York, Ogden, Omaha, Overland Park, Palm Springs, Philadelphia, Phoenix, Pomona, Portland, Providence, Reno, Rochester, Salisbury, St Louis, and Winston-Salem, United StatesSee the 37 sites
- Phase
- Phase 4
Could this be for you?
Answer for yourself. This is not a decision: only the study team can say whether you can take part.
- Are you between 18 and 70 years old?
Source: NCT06972056, who can take part
Where in United States
- University of Colorado Anschutz Medical CampusAurora, United StatesTaking people
- Onsite Clinical Solutions BallantyneCharlotte, United StatesTaking people
- Onsite Clinical Solutions MecklenburgCharlotte, United StatesTaking people
- Onsite Clinical Solutions Park Cedar Dr.Charlotte, United StatesTaking people
- Ohio State University Wexner Medical CenterColumbus, United StatesTaking people
- JFK Neuroscience InstituteEdison, United StatesTaking people
- Northern Arizona HealthcareFlagstaff, United StatesTaking people
- Apogee Clinical ResearchHazel Green, United StatesNot yet recruiting
- Memorial HealthcareHollywood, United StatesTaking people
- Clinical Trials of New EnglandHyde Park, United StatesTaking people
- Mayo Clinic FloridaJacksonville, United StatesTaking people
- Nuvance Health InstituteKingston, United StatesTaking people
- Clinical Research InstituteLos Angeles, United StatesTaking people
- Keck School of Medicine of USCLos Angeles, United StatesTaking people
- Northwell HealthManhasset, United StatesTaking people
- Marshfield Clinic Research InstituteMarshfield, United StatesTaking people
- DHR Health Headache CenterMcAllen, United StatesTaking people
- Apple Med ResearchMiami, United StatesTaking people
- University of MiamiMiami, United StatesTaking people
- The Medical College of WisconsinMilwaukee, United StatesTaking people
- West Virginia UniversityMorgantown, United StatesTaking people
- Vanderbilt Medical CenterNashville, United StatesTaking people
- Mt Sinai Icahn School of MedicineNew York, United StatesTaking people
- Advanced Research Institute OgdenOgden, United StatesTaking people
- Nebraska Medical CenterOmaha, United StatesTaking people
- Neuroscience Research CenterOverland Park, United StatesTaking people
- Desert Physicians Medical GroupPalm Springs, United StatesTaking people
- University of PennsylvaniaPhiladelphia, United StatesTaking people
- Mayo Clinic - ArizonaPhoenix, United StatesTaking people
- The Neurology GroupPomona, United StatesTaking people
- Advanced Research InstitutePortland, United StatesTaking people
- Brown University HealthProvidence, United StatesTaking people
- Advanced Research Institute - RenoReno, United StatesTaking people
- Mayo ClinicRochester, United StatesTaking people
- Onsite Clinical Solutions SalisburySalisbury, United StatesTaking people
- Washington University St. LouisSt Louis, United StatesTaking people
- Wake Forest University HealthWinston-Salem, United StatesTaking people
Questions to ask the study team
- How often do I need to come in, and for how long each time?
- Are travel costs paid?
- Can I keep my own doctor?
- What happens if I want to stop?
Trial details
- Who runs it
- Mayo Clinic
- Trial code
- NCT06972056
- Record updated
- 19 October 2026
- Original description
This goal of this study is to compare three medications used for migraine preventive treatment.Read full original descriptionShow less
A Comparative Effectiveness Study of Oral Medications Used for Migraine Prevention: The APT Comparison 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.
Inclusion: 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; Willingness and ability to provide informed consent; Willingness and ability to complete all research visits.
Exclusion: Currently taking atogepant, propranolol, or topiramate*; Previously took atogepant, propranolol, or topiramate*; Current use of a CGRP-targeting preventive medication or beta-blocker; Migraine preventive treatment has been started or dose has been changed within 12 weeks prior to potential enrollment; Used opioids or butalbital on five or more days per month on average for at least 3 months prior to enrollment; Secondary headache disorders (medication overuse headache is not an exclusion); Current or past epilepsy; Severe hepatic impairment; Moderate or more severe renal impairment * Occasional as needed use of propranolol, currently or in the past, is not an exclusion, such as taking as needed propranolol for treatment of anxiety; Contraindications to taking atogepant, propranolol, or topiramate; Unwillingness to take atogepant, topiramate, or propranolol; Migraine with brainstem aura; Hemiplegic migraine; Retinal migraine; Migraine aura without headache (exclusively); Pure menstrual migraine; Trigeminal autonomic cephalalgias; Facial neuralgias.