Eptinezumab for The Preventive Treatment of Migraine

Abstract

Our knowledge of the pathophysiology of migraine and the molecules implicated in the disorder have evolved over time. Among these, calcitonin gene-related peptide has shown a crucial role that led to the development of therapies specifically targeting the molecule. Four monoclonal antibodies targeting the calcitonin gene-related peptide pathway are currently available after the US FDA approval of eptinezumab for the indication of migraine prevention. This is the only one of the class to be administered intravenously. The pharmacology of eptinezumab and the four studies that led to the approval, two Phase II and two Phase III clinical trials, are reviewed in this paper. Eptinezumab has demonstrated efficacy, tolerability and safety in patients with episodic and chronic migraine. Studies including migraineurs who have failed previous preventives, and comparison with other options administered quarterly, as well as real-world experience data will all be welcome.

Lay abstract

Eptinezumab belongs to a group of four currently available drugs that target a molecule produced by nerve cells and plays an important role in migraine. It is the only one of this group of drugs that can be injected intravenous and has been approved by the US FDA to treat migraine. In this article, we reviewed the general properties of eptinezumab and the four studies that led to its approval.

Keywords::

• CGRP
• CGRP monoclonal antibody
• eptinezumab
• migraine
• migraine prevention
• new migraine treatment

Author contributions

MV Martínez performed the review and drafted the manuscript. DM Ajona performed the review and drafted the manuscript. PJ Goadsby reviewed and edited the manuscript for intellectual content. All authors read and approved the final manuscript.

Financial & competing interests disclosure

PJ Goadsby reports, over the last 36 months, grants and personal fees from Amgen and Eli-Lilly and Company, grant from Celgene, and personal fees from Alder Biopharmaceuticals, Aeon Biopharma, Allergan, Biohaven Pharmaceuticals Inc., Clexio, Electrocore LLC, eNeura, Epalex, GlaxoSmithKline, Impel Neuropharma, Lundbeck, MundiPharma, Novartis, Pfizer, Sanofi, Santara Therapeutics, Teva Pharmaceuticals, Trigemina Inc., WL Gore and personal fees from MedicoLegal work, Massachusetts Medical Society, Up-to-Date, Oxford University Press and Wolters Kluwer; and a patent magnetic stimulation for headache assigned to eNeura without fee. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.