Long-term Reductions in Monthly Headache Days With Eptinezumab Treatment in Adults With Chronic Migraine: Results From the PREVAIL Study
Amaal Starling1, David Kudrow2, Neha Kapur3, Susanne Awad4, S. Wald Grossman3, Foram Patel3, Jessica Ailani5
1Mayo Clinic Arizona, 2California Medical Clinic for Headache, 3Lundbeck LLC, 4H. Lundbeck A/S, 5MedStar Georgetown University Hospital
Objective:

This post-hoc analysis of PREVAIL evaluated the proportion of patients with ≥50% or ≥75% reduction in monthly headache days (MHDs; based on Migraine Disability Assessment [MIDAS]) at Weeks 12 or 24 who sustained that reduction through subsequent 12-week dosing intervals up to Week 84.

Background:

The phase 3 PREVAIL single-arm, open-label, long-term safety study showed a favorable safety profile consistent with previous trials and reductions in migraine burden over 2 years in patients treated with eptinezumab.

Design/Methods:

PREVAIL was a single-arm, open-label trial evaluating long-term outcomes of eptinezumab treatment in adults aged 18-65 years with chronic migraine. Patients received eptinezumab 300 mg intravenously every 12 weeks. This post-hoc analysis evaluated the proportion of patients with ≥50% or ≥75% reduction in MHDs, based on the reduction in MIDAS-derived headache frequency after the first or second dosing intervals (Weeks 12 or 24, respectively), who sustained that reduction through the remaining 12-week dosing intervals up to Week 84.

Results:
Of 128 patients in PREVAIL, 100 had complete MIDAS-derived headache frequency data through Week 84 and were included in this post-hoc analysis. Of 78 (78%) patients with ≥50% reduction in MHDs at Week 12, 78% (61) sustained that reduction through the remaining study dosing intervals (up to Week 84). Similarly, of 77 (77%) patients with ≥50% reduction in MHDs at Week 24, 83% (64) sustained that reduction through the remaining dosing intervals. Of the patients with ≥75% reduction in MHD at Week 12 (63 patients [63%]) and Week 24 (55 patients [55%]), 54% (34) and 69% (38), respectively, sustained that reduction through the remaining dosing intervals.
Conclusions:

More than half of patients with ≥50% or ≥75% reduction in MHDs after the first or second dose experienced sustained reductions in headache frequency with continued eptinezumab treatment, indicating that early response may predict sustained response.

10.1212/WNL.0000000000211228
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