A Review of Eptinezumab Use in Migraine

Abstract

We present a review of the efficacy and safety profile of eptinezumab (also known by the brand name Vyepti), a calcitonin gene-related peptide (CGRP) monoclonal antibody (mAb) developed by Lundbeck Seattle BioPharmaceuticals, Inc., that received its first approval in the USA on 21 February 2020 for the preventive treatment of migraine in adults. It is administered by an intravenous infusion at a 100 mg dose every 3 months and shows no drug interactions.Studies have shown that eptinezumab is an effective preventative medication in migraine which starts showing its effect from day 1 of its administration, which maintains a consistent level of efficacy through a year of its treatment at doses 100 mg and 300 mg. It was found to be effective at reducing time to headache pain freedom during acute migraine attacks as well.Eptinezumab is a relatively safe drug for the prevention of migraines with treatment-related adverse events occurring at a low frequency. They bear a safe profile in patients with comorbidities like obesity and type 1 diabetes. The most frequent adverse events observed were nasopharyngitis, upper respiratory tract infections (URTIs), and sinusitis and were usually mild. The development of anti-drug antibodies was common, but they declined to undetectable levels with continued dosing and did not appear to impact the overall safety profile of the drug. Further studies are needed to assess long-term safety, use in different patient populations, and to compare its efficacy to other drugs of its class.

Efficacy and safety of eptinezumab as preventive treatment for episodic/chronic migraine: A systematic review and meta‐analysis

“…37,38 By reducing the number of CGRP receptor activation, the vasodilation and neurogenic inflammation process may also be reduced, which will then disrupts the pain impulse transmission to the brain and prevent migrainous pain. 39 The efficacy and safety of eptinezumab for migraine prevention was similar to the recently United States Food and Drug Administration (FDA)-approved drug for preventive treatment of episodic migraine, atogepant. Results from recent meta-analysis study showed that 10 and 30 mg of atogepant treatment was associated with reduction in mean migraine days from baseline to 12-week treatment without increasing the incidence of AEs, and therefore, is considered effective and well-tolerated for prevention of episodic migraine in adults.…”

“…It works by binding the free CGRP peptide, therefore, preventing the interaction between CGRP and its receptor 37,38 . By reducing the number of CGRP receptor activation, the vasodilation and neurogenic inflammation process may also be reduced, which will then disrupts the pain impulse transmission to the brain and prevent migrainous pain 39 …”

Calcitonin Gene-Related Peptide (CGRP)-Targeted Monoclonal Antibodies and Antagonists in Migraine: Current Evidence and Rationale

“…Five patients (3.9%) experienced a serious AE (only one was considered related to eptinezumab), and the rate of study-drug discontinuation due to AEs was 6.3%. Several on-going studies are assessing eptinezumab in pediatric populations (NCT04537429 and NCT04965675), and RWD are still being collected [ 88 ].…”

Management of Chronic Migraine in Children and Adolescents: Where are We in 2022?

“…71 In adults, antagonism of the CGRP pathway is associated with diminished headache days and medication usage. 72 Monoclonal antibodies (mAbs) to CGRP or its receptor-which require subcutaneous (erenumab, galcanezumab, fremanezumab) or intravenous administration (eptinezumab)-have shown safety and efficacy in trials of adults with migraine, [73][74][75][76][77] some with open-label data for 1 to 5 years. 78,79 To date, there are no published placebo-controlled trials of mAbs in children and adolescents with migraine.…”