Real-world Effectiveness of Intravenous Eptinezumab in Patients with Chronic Migraine and Previous Subcutaneous Preventive Migraine Treatment
Charles Argoff1, Steven Herzog2, Ryan Smith3, Seema Soni-Brahmbhatt4, Susanne Awad5, Divya Asher4, Fawad Khan6
1Albany Medical Center, 2Texas Neurology, 3St Luke's Clinic, 4Lundbeck LLC, 5H. Lundbeck A/S, 6The McCasland Family Comprehensive Headache Center, Ochsner Neurosciences Institute
To evaluate whether prior use of subcutaneous anti–calcitonin gene-related peptide (anti-CGRP) monoclonal antibodies (mAbs) impacts the real-world effectiveness of eptinezumab in patients with chronic migraine (CM).
Since 2018, several CGRP-targeted therapies have entered the migraine market, including eptinezumab. Minimal evidence exists evaluating the real-world effectiveness of switching from a subcutaneous to an intravenous anti-CGRP mAb.

An observational, multi-site (n=4), US-based study, REVIEW evaluated real-world experiences of patients with CM treated with eptinezumab using a retrospective chart review, patient survey, and semi-structured physician interview. Adults (≥18 years) with a diagnosis of CM who had completed ≥2 consecutive eptinezumab infusion cycles were eligible. This patient survey analysis focused on the effectiveness of eptinezumab in patients stratified by prior exposure to anti-CGRP mAbs (type and number).

Enrolled patients were primarily female (83%, 78/94), had a mean age of 49 years and a mean migraine diagnosis duration of 15.4 years. All patients (94/94) self-reported prior preventive therapy with 89% (84/94) reporting prior subcutaneous anti-CGRP mAb use (i.e., fremanezumab, galcanezumab, or erenumab). Of those who received >1 subcutaneous anti-CGRP prior to eptinezumab, 32% reported one switch (i.e., one anti-CGRP prior to eptinezumab), 38% reported two switches, and 30% reported three switches. Before eptinezumab, patients reported a mean of 8 “good” days/month, which increased to 18 “good” days/month following treatment. Regardless of prior exposure to a CGRP ligand or receptor blocker, the number of “good” days/month more than doubled following eptinezumab. Patients experienced a similar mean change in the number of “good” days/month regardless of the number and type of previous subcutaneous anti-CGRP mAbs used.
This real-world, patient survey showed that patients with prior exposure to subcutaneous anti-CGRP mAbs had high overall satisfaction with the effectiveness of eptinezumab treatment regardless of the number and type of previous therapies used.