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

Abstract

Migraine, the third most common neurological disorders worldwide, can cause significant burden to the patients. Currently, it has been found that calcitonin gene-related peptide (CGRP) has a significant role in pathophysiology of migraine. This study sought to analyse the efficacy and safety of eptinezumab, one of the CGRP-monoclonal antibody as preventive treatment for episodic/chronic migraine. Specific keywords were used to comprehensively go through the potential articles on ClinicalTrials.gov, Europe PMC, Scopus and PubMed databases until April 2022. All published randomized clinical trials (RCTs) on eptinezumab and migraine were gathered. Statistical analysis was conducted by using Review Manager 5.4 and Comprehensive Meta-Analysis version 3 software. There were four RCTs with 2739 migraine patients in the meta-analysis. In terms of efficacy, our analysis revealed that eptinezumab corresponded with higher reduction in monthly migraine days from baseline to week 12 (standardized mean difference, À0.34 [95% confidence interval (CI), À0.41, À0.28], P < 0.00001; I 2 = 0%), higher 75% and 50% migraine responder rate, reduction in rate of migraine on day-1 after dosing, lower headache impact test-6 score on week 4 and week 12. In terms of safety, eptinezumab has comparable adverse events when compared with placebo (risk ratio, 1.01 [95% CI 0.96-1.07], P = 0.63, I 2 = 0%). Further regression analysis also revealed that the association between eptinezumab and each outcomes of interest were not influenced by age, gender, body mass index and duration of migraine. This study proposes that eptinezumab is generally effective and safe for the preventive treatment of episodic or chronic migraine.

Real-world effectiveness of fremanezumab in patients with migraine switching from another mAb targeting the CGRP pathway: a subgroup analysis of the Finesse Study

“…CGRP is expressed in the trigeminal ganglion and is increased in the cranial venous outflow during acute migraine attacks. Specific antibodies either targeting the CGRP ligand (galcanezumab [ 7 ], fremanezumab [ 8 ], eptinezumab [ 9 ]) or the receptor (erenumab [ 10 ]) were developed and approved by the Food and Drug Administration (FDA) and European Medicines Agency (EMA). The diverse mechanisms of action of CGRP receptor versus ligand monoclonal antibodies may differentially affect efficacy, safety, and/or tolerability in migraine patients.…”

Chronic Migraine as a Primary Chronic Pain Syndrome and Recommended Prophylactic Therapeutic Options: A Literature Review

“…Eptinezumab reduces the MMDs, increases the 75% and 50% migraine responder rates, and decreases the HIT-6 score both on week 4 and week 12. Eptinezumab showed similar incidence AEs compared to the placebo [ 118 ].…”

Eptinezumab for the preventive treatment of episodic and chronic migraine: a narrative review

“…Results for the primary endpoint and key secondary endpoints of each study are presented. This review aims to build upon existing reviews of eptinezumab (43)(44)(45) by providing updated information from recently published studies and offering a detailed description of ongoing research.…”