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Background and Importance In recent years, monoclonal antibodies targeting calcitonin gene-related peptide (CGRP) have provided a new alternative for the preventive treatment of migraine in patients who have experienced multiple previous therapeutic failures. The recent approval of atogepant, a new oral anti-CGRP, offers advantages in terms of convenience, adherence, and costs reduction. Nevertheless, several cases of treatment discontinuation have been identified by the Pharmacy Department.Aim and Objectives The aim of this study is to evaluate the persistence of atogepant in a real-life setting and to identify the main reasons for discontinuing treatment.Material and Methods Observational, descriptive and retrospective study, which included patients who started treatment with atogepant between July 2024-November 2024.Variables collected were: sex, age, diagnosis (chronic or episodic migraine), previous anti-CGRP treatments, adverse reaction (AR), date and reason for discontinuing treatment. Persistence was defined by the length of time between the first dispensation, to treatment discontinuation or the end of follow-up in September 2025. Continuous variables are expressed as median while categorical variables as frequency and percentage. All information was collected from electronic medical records and analysed using the R statistical programme (v.4.2.2).Results A total of 55 patients were included, 43 (78,2%) women, with a median age of 49 years. 50 (90,9%) were diagnosed with chronic migraine and 30 (54,5%) had previously been treated with an anti-CGRP monoclonal antibody, 23 (41,8%) with galcanezumab and 7 (12,7%) with erenumab.At the end of the follow-up 39 (70,9%) patients had discontinued the treatment with atogepant, with a median persistence of 176,6 days. Half (53,8%) had been treated previously with monoclonal antibody. The main reasons for discontinuation were AR (56%) and lack of effectiveness (42%). The most common AR were nausea 30,9%, constipation 29,1% and fatigue 25,5%.Conclusion and Relevance Atogepant showed limited persistence, most of the patients discontinuing treatment within the first 6 months, mainly due to AR and lack of effectiveness. Although oral administration represents a convenient alternative to monoclonal antibodies, further studies are needed to better select patients who could benefit from this therapy.Conflict of Interest No conflict of interest