IV eptinezumab yields rapid, steep decreases in monthly migraine days

  • Lipton RB & al.
  • Neurology
  • 24 Mar 2020

  • curated by Kelli Whitlock Burton
  • Clinical Essentials
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Takeaway

  • Patients with chronic migraine treated with IV eptinezumab reported about a 50% decrease in monthly migraine days (MMDs) during a 12-week period, a significantly greater decrease compared with patients who received a placebo.
  • The preventative effects from eptinezumab were reported as early as 1 day after treatment.

Why this matters

  • Patients with migraine report the speed of preventive benefit as a primary concern of treatment.  

Study design

  • PROMISE-2, phase 3, multicenter, randomized double-blind, placebo-controlled, parallel-group study of 1121 patients (age range, 18-65 years) with migraine who were randomly assigned (1:1:1) to receive eptinezumab 100 mg, eptinezumab 300 mg, or placebo.  
  • Outcome: reduction in MMDs.
  • Funding: H. Lundbeck A/S, Copenhagen, Denmark.

 Key results

  • Over 12-week duration, treatment with eptinezumab 100 and 300 mg vs placebo:
    • Reduced mean MMDs: −7.7 and −8.2 vs −5.6 (P<.0001>
    • Achieved ≥50% migraine responder rate: 57.6% and 61.4% vs 39.3% (P<.0001>
  • The reduction in migraine on day 1 after treatment was higher in the eptinezumab groups vs placebo (50.3% 100 mg and 51.6% 300 mg vs 27.1% placebo; all P<.0001>
  • The percentages of patients with any treatment-emergent adverse events were similar across study groups (43.5% 100 mg, 52.0% 300 mg, and 46.7% placebo).

Limitations

  • Self-reported data.

Coauthored with Vijay Rathod PhD