Effectiveness and Safety of Eptinezumab in Episodic and Chronic Migraine Headache in the UAE: A Retrospective Study

Abstract

Introduction Eptinezumab is a humanized IgG1 immunoglobulin monoclonal antibody administered intravenously as a preventative migraine treatment. Previously conducted randomized, double-blind, placebo-controlled trials exhibited significant reductions in monthly migraine frequency among adults experiencing episodic and chronic migraine. The present study seeks to expand upon the current findings and to evaluate eptinezumab’s efficacy as a preventative treatment for chronic and episodic migraine patients in the United Arab Emirates. This study is intended to represent the first real-world evidence and will hopefully serve as a valuable complement to the existing literature on the subject. Methods This was a retrospective exploratory study. The participants included within the study were adult (≥ 18 years) patients diagnosed with either episodic or chronic migraine. Patients were categorized according to their history of previous preventative treatment failure. For the final assessment of treatment efficacy, we included only patients with a minimum of 6 months of clinical follow-up data. Patients were assessed at baseline for their monthly migraine frequency and assessed again at months 3 and 6. The primary objective was to evaluate the efficacy of eptinezumab in reducing migraine frequency among chronic and episodic migraine patients. Results A total of 100 participants were identified, of whom 53 completed the study protocol at month 6. Of the total, 40 (75.47%) were female, 46 (86.79%) were Emirati locals, and 16 (30.19%) were pharmaceutically naïve, having never tried any prior preventative therapy. Additionally, 25 (47.17%) patients met the criteria for chronic migraine (CM), whereas the remaining 28 (52.83%) were diagnosed with episodic migraine (EM). The baseline monthly migraine frequency (MMD) was 12.23 (4.97) days across all participants, 15.56 (3.97) for CM patients, and 9.25 (3.76) for EM patients; by month 6, these frequencies reduced to 3.66 (4.21), 4.76 (5.32), and 2.68 (2.61), respectively. Overall, 58.49% of those enrolled experienced > 75% reduction in MMD frequency by month 6. Conclusion Patients enrolled in this trial experienced clinically significant reductions in MMD by month 6. Eptinezumab was well tolerated and with one AE of significance that led to discontinuation from the study.

Real-world effectiveness and satisfaction with intravenous eptinezumab treatment in patients with chronic migraine: REVIEW, an observational, multi-site, US-based study

“…Remarkably, this study demonstrated that patients experiencing continued migraine burden who had previously tried other anti-CGRP mAb preventive treatments responded positively to eptinezumab; this suggests empirically that exposure and trial of one anti-CGRP mAb does not necessarily preclude a positive response to eptinezumab treatment. Recent studies also corroborate this finding [22][23][24][25], with one study showing that patients with previous exposure to erenumab or galcanezumab who subsequently initiated eptinezumab treatment had an overall reduction in monthly migraine days of ∼ 8.4 and ∼ 8.2, respectively, over a 6-month period [22]. These findings have implications for public health and best practices for clinicians navigating through treatment decisions among a variety of advanced migraine therapies.…”

Effectiveness and tolerability of eptinezumab in treating patients with migraine resistant to conventional preventive medications and CGRP (receptor) antibodies: a multicentre retrospective real-world analysis from Germany

“…They found a significant difference in MMD after three months for patients who were naïve and for patients who were previously treated with erenumab or galcanezumab in (mean MMD after three months (SD): naïve: 2.13 (1.86); erenumab: 5.69 (5.96); galcanezumab: 7.47 (6.77), respectively; p < 0.001). After dosage increase from 100 to 300mg in 14 patients, MMD did not differ after six months (mean MMD after six months (SD): naïve: 3.25 (4.27); erenumab: 3.63 (4.86); galcanezumab: 3.82 (2.67)) [ 9 ]. The responder rates after 3 months were better than in our cohort, but after six months a remarkable better response was seen.…”

Migraine and Its Treatment from the Medicinal Chemistry Perspective

“…This is the only drug used as an intravenous infusion, thus offering pharmacokinetic advantages over mAbs used subcutaneously. 124 6. 3 reported to relieve pain within 2 h and greatly reduce the frequency of migraine attacks.…”

“…This is the only drug used as an intravenous infusion, thus offering pharmacokinetic advantages over mAbs used subcutaneously. 124 6.3.2. Gepants.…”

“…It specifically binds to CGRP and blocks CGRP-related pain signaling pathways. This is the only drug used as an intravenous infusion, thus offering pharmacokinetic advantages over mAbs used subcutaneously …”