Every new migraine preventive since 2018 targets CGRP. MTX-101 offers another route, by mouth.
Migraine is a $5B+ market, and CGRP antibodies alone account for about 55% of its revenue. The patients those drugs don't reach are the opportunity.
Where MTX-101 fits
Migraine preventives sorted by mechanism and route. Approved and late-stage products fill three of the four quadrants.
Qulipta, Nurtec
Approved oral CGRP drugs
MTX-101
The only oral non-CGRP preventive in development
Vyepti and CGRP antibodies
Approved, given by injection or quarterly infusion
Bocunebart, Botox
Lundbeck's PACAP antibody reported positive Phase 2b data in June 2026. Botox requires 31 injections per treatment cycle.
Positioning only. No head-to-head trials exist, and these programs studied different patient populations.
The unmet need
Many patients go untreated
About 44 million Americans have migraine, and about 3.5 million have chronic migraine. Only around 500,000 of them are treated.
CGRP doesn't work for everyone
About a third of CGRP-treated patients never reach a 50% reduction in migraine days. The oral CGRP drugs share the same pathway, so switching within the class has limits.
Route drives discontinuation
Adherence to oral preventives falls below 30% at six months. Beyond CGRP, the remaining options are Botox injections or quarterly infusions.
Who MTX-101 fits
Manistee is open to an acquisition of the company or an out-license of MTX-101.
Migraine franchise owners
An oral next-line option keeps CGRP non-responders in the franchise instead of losing them to Botox.
CNS and specialty pharma
A preventive to pair with an existing neurology call point or acute migraine product.
Global and ex-US partners
A differentiated neurology product for commercial infrastructure across the US, Europe and Japan.
Review the commercial assessment
Market sizing, pricing assumptions and valuation are available to qualified parties under a confidentiality agreement.