As AI reshapes how people discover health information, knowing how models perceive and present your brand, and your competitors, is quickly becoming mission-critical for competitive insights, PR, and sales and marketing.
Most biopharma and healthcare teams are fluent in search and social marketing. What is less understood is which sources AI systems draw from (and how they weigh them) when answering patient questions about a drug or treatment.
As we continue upgrading our LucidSearch engine (https://www.lqventures.com/lucidsearch/), we’re building in:
- GEO (Generative Engine Optimization): optimizing content to surface in AI-generated results
- AIO (AI Optimization): making content easy for AI systems and LLMs to summarize, recommend, or cite
- AEO (Answer Engine Optimization): positioning content to appear as the direct answer in featured snippets and voice search
In this article, we share our findings from the migraine landscape across several CGRP blockers (Ajovy, Aimovig, Emgality, Vyepti, Nurtec ODT, Qulipta, Ubrelvy, and Zavzpret).
Drawing on clinical efficacy data, patient safety considerations, and market sentiment, this briefing highlights how these brands are perceived and discussed within an AI-driven web search synthesis, so brand owners can see not just where they show up, but why.
Please note, all text below is intentionally fully AI-generated, based on results from our proprietary AI-search tool, in order to capture the AI’s way of searching, thinking and synthesizing information. Feel free to reach out at iamq@lqventures.com for further information on the process, prompts used and how you could gain access to the tool to test with your brand(s).
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Overview of Migraine Treatments
The migraine treatment market primarily focuses on therapies targeting the calcitonin gene-related peptide (CGRP) pathway. These treatments are broadly categorized into two types:
- Monoclonal Antibodies (mAbs): These bind to either the CGRP ligand or its receptor, preventing CGRP from activating its receptor.
- Ajovy (fremanezumab), Emgality (galcanezumab), and Vyepti (eptinezumab) bind to the CGRP ligand.
- Aimovig (erenumab) targets the CGRP receptor directly.
- Small-Molecule CGRP Receptor Antagonists (Gepants): These orally or nasally administered drugs block the CGRP receptor.
- Nurtec ODT (rimegepant), Qulipta (atogepant), Ubrelvy (ubrogepant), and Zavzpret (zavegepant) are gepants.
Administration Routes and Dosing:
- Ajovy and Emgality: Subcutaneous injection, with Ajovy offering monthly (225 mg) or quarterly (675 mg) dosing.
- Vyepti: Intravenous infusion every three months.
- Aimovig: Monthly subcutaneous injection.
- Nurtec ODT: Oral, every other day for prevention, or as needed for acute treatment.
- Qulipta: Oral, once daily for prevention.
- Ubrelvy: Oral tablet for acute treatment.
- Zavzpret: Nasal spray for acute treatment.
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Clinical Efficacy Comparison
While direct head-to-head comparisons are limited, clinical trials demonstrate the efficacy of these medications in reducing migraine frequency and severity.
Preventive Treatments:
- Ajovy: Reduced monthly migraine days by approximately 4.3 days in chronic migraine patients, compared to 2.5 days with placebo (pmc.ncbi.nlm.nih.gov).
- Aimovig: Showed a reduction of about 3.2 days for episodic migraine and 6.6 days for chronic migraine, compared to 1.8 and 4.2 days with placebo, respectively (pmc.ncbi.nlm.nih.gov).
- Emgality: Demonstrated a reduction of approximately 4.7 days for chronic migraine patients, compared to 2.8 days with placebo (pmc.ncbi.nlm.nih.gov).
- Vyepti: Reduced monthly migraine days by about 4.0 days for chronic migraine patients, compared to 2.1 days with placebo (pmc.ncbi.nlm.nih.gov).
- Nurtec ODT: Taken every other day, showed a reduction of approximately 4.3 days, compared to around 2.0 days with placebo (drugs.com).
- Qulipta: Taken daily, showed a reduction of about 4.2 days, compared to around 2.0 days with placebo (drugs.com).
Acute Treatments:
- Nurtec ODT: Provided pain relief within two hours for approximately 59% of patients, compared to 43% with placebo (virtualheadachespecialist.com).
- Ubrelvy: Demonstrated pain relief at two hours in about 62% of patients, compared to 49% with placebo (virtualheadachespecialist.com).
- Zavzpret: Showed pain relief at two hours in approximately 59% of patients, compared to 50% with placebo (virtualheadachespecialist.com).
Comparative Insight: A meta-analysis indicated that traditional triptans might be more effective in acute migraine treatment compared to newer gepants (fiercepharma.com).
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Patient Safety Concerns and Side Effects
Specific to CGRP-Targeting Therapies:
The newer CGRP-targeting therapies are generally well-tolerated.
- Monoclonal Antibodies: Common side effects include injection site reactions.
- Oral Gepants: Common side effects include nausea.
- Cardiovascular Safety: Gepants notably do not cause vasoconstriction, making them a safer option for patients with pre-existing cardiovascular concerns (virtualheadachespecialist.com).
General Medication Safety Concerns:
It is important to note that the broader analysis of patient safety concerns also highlighted several general issues applicable to all medications, which brand owners should be aware of in a comprehensive safety profile:
- Side Effects: Ranging from mild (nausea, dizziness, drowsiness) to severe (organ damage, cardiovascular issues, neurological problems) (betterhealth.vic.gov.au, en.wikipedia.org).
- Drug Interactions: Combining medications can alter effectiveness or cause adverse reactions, particularly with polypharmacy (concurrent use of five or more medications), leading to complications like falls or cognitive decline (en.wikipedia.org).
- Overmedication and Polypharmacy: Prescribing more medications than clinically necessary increases risks, especially in the elderly, emphasizing the need for regular medication reviews (en.wikipedia.org).
- Medication Errors: Incorrect dosages, wrong medications, or miscommunication among healthcare providers can have serious consequences (ncbi.nlm.nih.gov).
- Dependency and Addiction: High potential with certain medications like opioids and benzodiazepines, requiring close monitoring and patient education (en.wikipedia.org).
- Allergic Reactions: Ranging from mild rashes to severe anaphylaxis, necessitating thorough allergy history collection (betterhealth.vic.gov.au).
- Organ Damage: Long-term or excessive use can lead to organ damage (e.g., acetaminophen causing liver failure, NSAIDs causing kidney damage) (en.wikipedia.org).
- Antibiotic Resistance: Overprescription and misuse of antibiotics contribute to resistance, making infections harder to treat (en.wikipedia.org).
- Health Literacy: Low health literacy can lead to misunderstandings about medication instructions and improper use (en.wikipedia.org).
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Market Sentiment and Patient Feedback
The migraine treatment market is highly competitive and dynamic, with a noticeable shift towards oral medications due to patient preference for non-injectable options. Affordability and insurance coverage remain significant factors.
- Ajovy (fremanezumab):
- Market Sentiment: Offers flexible monthly or quarterly dosing for prevention. Its market share has been impacted by the rise of oral alternatives.
- Patient Feedback: Patients appreciate its efficacy, but some have concerns about the injection process and potential side effects.
- Aimovig (erenumab):
- Market Sentiment: As one of the first CGRP inhibitors, it set a precedent but faces strong competition, leading to a relatively flat projected share.
- Patient Feedback: Users report varying experiences, with some finding relief while others mention side effects or diminishing effectiveness over time.
- Emgality (galcanezumab):
- Market Sentiment: A significant player in prevention, though a head-to-head trial indicated it did not outperform Nurtec in preventing episodic migraines (fiercepharma.com).
- Patient Feedback: Patients often commend its efficacy but note the inconvenience of injections and occasional side effects.
- Vyepti (eptinezumab):
- Market Sentiment: Unique as an intravenous infusion for prevention. Its higher cost and need for clinical administration limit accessibility.
- Patient Feedback: Some patients value its efficacy, especially non-responders to other treatments, but the infusion process can be a barrier.
- Nurtec ODT (rimegepant):
- Market Sentiment: Gained significant traction with dual approval for acute and preventive treatment. High physician satisfaction and a growing patient base (prnewswire.com).
- Patient Feedback: Patients appreciate its dual functionality and convenient oral disintegrating tablet form.
- Qulipta (atogepant):
- Market Sentiment: A strong contender in prevention with high physician satisfaction. Oral dosing is preferred over injectables (prnewswire.com).
- Patient Feedback: The once-daily oral regimen is highly favored, especially by patients averse to injections.
- Ubrelvy (ubrogepant):
- Market Sentiment: Well-received as an acute treatment, particularly for patients seeking alternatives to triptans.
- Patient Feedback: Users highlight its effectiveness in aborting migraine attacks without the cardiovascular concerns associated with triptans.
- Zavzpret (zavegepant):
- Market Sentiment: A nasal spray for acute treatment, noted for its rapid action. Promising adoption rates among physicians (spherixglobalinsights.com).
- Patient Feedback: Patients appreciate the non-oral administration, especially those with nausea during migraines, though some report an unpleasant taste.
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Analysis of Sources and Weblinks
This briefing document is a result of an LLM’s (gpt-4o) synthesis of information, akin to performing web searches when posed with questions of comparing different brands. This approach offers valuable insights for brand owners on how their products are being discovered and understood through such AI systems.
The LLM utilized a diverse range of sources, indicating a comprehensive and multifaceted information-gathering strategy:
- Academic and Clinical Research Databases (pmc.ncbi.nlm.nih.gov, ncbi.nlm.nih.gov): These sources provide the foundational clinical efficacy data derived from studies and trials. For brand owners, this highlights the critical importance of strong, publicly accessible clinical trial results for establishing scientific credibility.
- Health Information Portals (drugs.com, betterhealth.vic.gov.au): These general health sites offer patient-friendly summaries of drug information, side effects, and administration details. Brands must ensure consistent and clear messaging on such widely accessed platforms to manage patient expectations and understanding.
- Specialized Medical/Patient-Focused Sites (virtualheadachespecialist.com): These sites often delve into comparative analyses from a practical, clinical perspective, addressing patient concerns like specific side effects or advantages for certain patient populations (e.g., cardiovascular concerns with gepants vs. triptans). This shows the LLM prioritizes real-world application and patient relevance.
- Pharmaceutical Industry News and Market Research (fiercepharma.com, prnewswire.com, spherixglobalinsights.com): These sources provide crucial market sentiment, competitive positioning, head-to-head trial outcomes, and physician/patient satisfaction data. This category is vital for brand owners, as it directly reflects brand perception, market share dynamics, and competitive performance—key factors an LLM will draw upon when asked to compare brands.
- General Knowledge/Encyclopedic Sources (en.wikipedia.org): Used to provide broader context on medication safety issues, such as polypharmacy, dependency, and organ damage. This indicates that when a prompt is broadly framed (e.g., “patient safety concerns”), an LLM will include general health warnings, not just drug-specific adverse events, to provide a complete picture. Brand owners should be aware that their drug’s safety profile might be contextualized within broader medication safety discussions.
Conclusion
The migraine treatment landscape offers diverse options with varying mechanisms, administration routes, and dosing schedules. The choice among these therapies should be individualized, considering the patient’s migraine pattern, treatment goals, comorbidities, and personal preferences. The evolving market, with a shift towards oral medications and increasing competition, necessitates a dynamic approach to brand positioning and communication. Understanding how an AI synthesizes information from various online sources is critical for brand owners to effectively manage their brand’s presence and perception in this competitive environment.
Key Takeaways
This eclectic mix of sources demonstrates the LLM’s ability to pull information from various layers of public discourse – from deep scientific data to market dynamics and general health advice. For brand owners, this indicates that a holistic online presence is crucial.
Performance in clinical trials, clear patient information, positive industry perception, and accurate portrayal on general health sites all contribute to how a brand is “discovered” and understood by an AI, which then shapes the narrative for users seeking comparative information.
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