Sustained migraine relief reported with long-term eptinezumab

Key takeaways:

• Patients treated with eptinezumab had significant improvement in migraine days per month and most bothersome symptoms.
• Improvement in disease state continued with long-term treatment.

AUSTIN, Texas — Long-term use of eptinezumab resulted in improvements in symptoms and headache days in patients with chronic migraine and medication-overuse headache, according to a poster presented here.

“We looked at our data in the context not only of chronic migraine but also medication overuse,” Lee Boyle, PhD, a medical science liaison at Lundbeck, told Healio. “What we found is that over time we still see improvements that continue in this patient population.”

This evaluation included data from the 2-year, phase 3, single-arm, open-label PREVAIL trial, in which patients received 300 mg eptinezumab every 12 weeks for up to 8 doses. Of 128 patients with chronic migraine, 49 (38%) had a secondary diagnosis of medication-overuse headache (mean age, 41.8 years; 82% women).

The percentage of patients with severe headache-related impact (HIT-6 total score 60) decreased from 92% at baseline to 27% at week 84 and 36% at week 104. Severe migraine-related disability (MIDAS total score 21) was identified in 86% of patients at baseline, which dropped to 8% at week 72, 16% at week 84 and 19% at week 104.

Additionally, mean MIDAS total score decreased from severe disability at baseline to minimal disability at week 84.

A reduction in headache days of at least 50% was reported by 72.9% of patients at week 12 and 83.8% at week 84.

Using the Patient Global Assessment of Change (PGIC) scale, 63% of patients reported a “much” or “very much” improved disease state at week 4, with 86% saying so at weeks 84 and 104.

Most bothersome migraine symptoms ranged from photophobia and phonophobia to nausea, pain with activity, vomiting and mental cloudiness.

Improvement in these symptoms was reported by 57% of patients at week 4, which increased to 67% at week 48.

“Not only did they improve with their disease state, they continued to improve with their most bothersome symptom, which usually is what impacts their life a lot more,” Boyle said. “We are seeing with this medication over time, we are still seeing benefits. We are still helping patients get back to normal function. They are no longer a migraine patient; they are a patient who is occasionally inconvenienced by migraine.”