IV eptinezumab proves effective for prevention of episodic migraine

  • Ashina M & al.
  • Cephalalgia
  • 19 Feb 2020

  • curated by Kelli Whitlock Burton
  • Clinical Essentials
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Takeaway

  • Patients with episodic migraine who received intravenous (IV) eptinezumab reported significantly fewer migraine days in the 12 weeks after treatment than those who received a placebo.

Why this matters

  • The migraine preventative benefit was reported as early as 1 day after treatment, and almost one-third of patients experienced a ≥75% decrease in migraine days during the first month.

Study design

  • PROMISE-I study of 888 patients (aged 18-75 years) with a diagnosis of migraine.
  • Outcomes: change in monthly migraine days (MMDs), ≥75% and ≥50% migraine responder rate.
  • Funding: H. Lundbeck A/S, Copenhagen, Denmark.

Key results

  • Patients treated with eptinezumab vs placebo were more likely to achieve ≥75% migraine response across 1-4 weeks:
    • 30 mg: 9.8% (P=.0170).
    • 100 mg: 10.5% (P=.0112).  
    • 300 mg: 11.3% (P=.0066).
  • MMDs were lower with eptinezumab vs placebo from baseline across weeks 1-12:
    • 30 mg: −4.0 (P=.0046).
    • 100 mg: −3.9 (P=.0182).  
    • 300 mg: −4.3 (P=.0001).
    • Placebo: −3.2.
  • Steeper ≥75% and ≥50% decreases, respectively, in migraine rates with eptinezumab vs placebo across 1-12 weeks were seen:
    • 30 mg: 24.70% (P=.0272) and 50.2% (P=.00064).
    • 100 mg: 22.2% (P=.1126) and 49.8% (P=.0085).
    • 300 mg: 29.7% (P=.0007) and 56.3% (P=.0001).
    • Placebo: 16.2% and 37.4%.

Limitations

  • Limited geographical diversity.
  • Small sample size.

Coauthered with Vijay Rathod, PhD