Long-term Maintenance of ≥50% and ≥75% Migraine Response With Eptinezumab in Patients With High-frequency Episodic Migraine and Chronic Migraine and 2-4 Prior Migraine Preventive Treatment Failures
Jessica Ailani1, Messoud Ashina2, Susanne Awad3, Neha Kapur4, S. Wald Grossman4, Seema Soni-Brahmbhatt4, Richard B. Lipton5
1Department of Neurology, Georgetown University Hospital, 2Department of Neurology, Danish Headache Center, Copenhagen University Hospital- Rigshospitalet Department of Clinical Medicine, University of Copenhagen, 3H. Lundbeck A/S, 4Lundbeck LLC, 5Department of Neurology, Albert Einstein College of Medicine
Objective:
This post hoc analysis of the DELIVER trial evaluated sustained ≥50% or ≥75% migraine responses over 72 weeks of eptinezumab treatment in patients with high-frequency episodic migraine (HFEM) or chronic migraine (CM).
Background:
In the phase 3b DELIVER trial, treatment with eptinezumab demonstrated long-term (72-week) reductions in migraine frequency, severity, and acute medication use, along with patient-reported improvements in quality of life.
Design/Methods:
In DELIVER, adults with migraine and 2-4 prior migraine preventive treatment failures completed a 24-week placebo-controlled period before entering a 48-week dose-blinded extension period (efficacy analysis population, N=858). This post hoc analysis included patients with CM (>14 monthly headache days [MHDs], of which ≥8 were monthly migraine days [MMDs]) or HFEM (≤14 MHDs, of which ≥8 were MMDs) at baseline (N=749; 87%) who were treated with eptinezumab (100 or 300 mg) and had a ≥50% or ≥75% reduction in MMDs (ie, migraine responder rate [MRR]) during the first dosing interval of the placebo-controlled period (Weeks 1-12). The proportion of patients who sustained those responses was evaluated through the 5 remaining, 3-month dosing intervals.
Results:
Among eptinezumab-treated patients with baseline HFEM or CM, the ≥50% MRR was 41% (203/492 [100 mg, n=97; 300 mg, n=106]), and the ≥75% MRR was 15% (75/492 [100 mg, n=35; 300 mg, n=40]) over Weeks 1-12. The ≥50% MRR during Weeks 1-12 was sustained through 72 weeks of treatment in 63% of patients with eptinezumab 100 mg and 75% of patients with eptinezumab 300 mg, while the ≥75% MRR was sustained in 37% (100 mg) and 65% (300 mg) of patients.
Conclusions:
These results demonstrate that early response to eptinezumab (≥50% and ≥75% MRRs after 1 dosing interval) is a predictor for sustained response in patients with HFEM or CM.
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