Conference Coverage

AAN 2026: Post Hoc Interim Analysis Shows Atogepant Weight Loss

Edited by:
Anthony Calabro, MA

Key Highlights

  • Atogepant 60 mg daily was associated with weight loss over 52 weeks.
  • Nearly 35% of participants achieved ≥5% weight reduction at 1 year.
  • Greater weight loss was observed among those meeting ≥5% and ≥10% thresholds.
  • Weight-related adverse events were infrequent and nonserious.

Interim findings presented at the 2026 American Academy of Neurology Annual Meeting in Chicago, IL, showed that atogepant 60 mg once daily was associated with weight loss in participants with migraine and overweight or obesity. The results come from a post hoc subgroup analysis of a phase 3, multicenter, open-label, 156-week extension study.

Atogepant has previously demonstrated dose- and duration-dependent weight loss in clinical trials. This analysis evaluated weight changes over 52 weeks among participants with elevated body mass index (BMI) at baseline.

Participants included in the analysis were drawn from the open-label extension study and had overweight or obesity at baseline in prior lead-in trials. Investigators used descriptive statistics to assess mean change in body weight, the proportion of participants achieving clinically meaningful weight loss (defined as ≥5% and ≥10% reductions), and mean weight change among those meeting these thresholds at week 52. Weight-related treatment-emergent adverse events (TEAEs) were also summarized.

Study Findings

Of 595 participants in the extension study, 279 met BMI criteria for overweight or obesity. The population was predominantly female (83.2%) and White (87.1%), with a mean (SD) age of 42.8 (11.7) years. At baseline, mean (SD) body weight was 85.6 (14.6) kg and BMI was 30.3 (4.8) kg/m². Participants experienced a mean (SD) of 14.6 (6.1) monthly migraine days. Most were classified as overweight (60.2%) or obesity class I (39.9%), and 62.7% had at least two cardiovascular risk factors, most commonly hypertension (54.8%) and dyslipidemia (10.4%).

Mean (SD) body weight decreased by 0.95 (3.57) kg as early as week 4 and reached a reduction of 3.44 (7.08) kg at week 52. At 1 year, 34.9% of participants achieved ≥5% weight loss, and 12.8% achieved ≥10% weight loss. Among participants with ≥5% weight reduction, mean (SD) weight loss was 10.00 (7.86) kg. Among those with ≥10% reduction, mean (SD) weight loss was 16.49 (9.86) kg. Weight-related TEAEs occurred in 1.8% of participants, with 0.4% reporting abnormal weight loss and 0.4% reporting abnormal weight gain; these events were not serious and did not lead to discontinuation.

Clinical Implications

According to the study authors, clinically meaningful weight loss was observed with atogepant 60 mg once daily over one year of open-label treatment in a migraine population with overweight or obesity, many of whom had cardiovascular risk factors.

Expert Commentary

“In a migraine trial subpopulation with cardiovascular risk factors, clinically meaningful weight loss was observed with atogepant 60 mg once daily throughout one year of open-label treatment. Nearly one-third of participants experienced a ≥5% weight reduction, averaging 10 kg of weight loss,” the researchers concluded.

Reference
Peterlin BL, Smith J, Ailani J, et al. Weight loss with atogepant in participants with migraine and overweight or obesity: interim analysis of a phase 3, multicenter, open-label, 156-week extension study. Presented at: American Academy of Neurology Annual Meeting; April 2026; Chicago, IL. https://www.aan.com/events/annual-meeting/abstracts#subnav.