Real-world Improvements in Cognitive Symptoms After Eptinezumab Treatment in Patients in Whom ≥1 Prior Anti-CGRP Preventive Treatment had Failed: 6-month Results for the Ongoing INFUSE Study
Emad Estemalik1, Richard Lipton2, Seema Soni-Brahmbhatt3, Stephane Regnier3, Susanne Awad4, S. Wald Grossman3, Michelle Townshend5, Amaal Starling6
1Cleveland Clinic Lerner College of Medicine, 2Albert Einstein College of Medicine, 3Lundbeck, 4H. Lundbeck A/S, 5ZS Associates, 6Mayo Clinic Arizona
Objective:

To describe migraine-related cognitive symptoms at baseline and changes observed during eptinezumab treatment in an interim analysis of the INFUSE study.

Background:

Migraine-related cognitive symptoms are common and disabling. In the REVIEW study, among the 80% of patients with brain fog at baseline, 86% reported improvements with eptinezumab treatment. This analysis of the ongoing INFUSE study assessed the impact of eptinezumab on broader migraine-related cognitive symptoms in an interim effectiveness population who received 2 infusions, completed baseline and Month 6 surveys, and reported brain fog/other cognitive symptoms at baseline.

Design/Methods:

INFUSE is a prospective cohort study evaluating real-world effectiveness of eptinezumab for preventive migraine treatment in adults for whom ≥1 prior preventive calcitonin gene-related peptide treatment had failed. Patient-reported outcomes are collected via web-based platform. Here, we report an interim analysis of cognitive symptoms through 6 months.

Results:

For 75 patients with available baseline data, most reported brain fog (difficulty concentrating/focusing, trouble finding right words/speaking, mental cloudiness; 92.0%), difficulty making decisions (73.3%), difficulty reading (81.3%), and difficulty with tasks (86.7%); these symptoms were considered moderately to extremely bothersome by 84.0%, 65.3%, 58.7%, and 65.3% of patients, respectively. In the interim effectiveness population (n=48), 57.8% of those reporting brain fog at baseline (n=45) showed improvement (minimally/much/very much improved) at Month 6 (after 2 eptinezumab doses). For patients with difficulty making decisions (n=34), 50.0% reported improvement at Month 6; for those with difficulty reading (n=40), 50.0% reported improvement at Month 6; and for those with difficulty with tasks (n=41), 51.2% reported improvement at Month 6. Marked improvements also occurred at Day 7.

Conclusions:

Migraine-related cognitive symptoms were highly prevalent and bothersome at baseline, underscoring the importance of addressing these symptoms in migraine management. Cognitive functioning improved following eptinezumab treatment in ≥50% of patients at Month 6, with measurable improvements in all domains within 7 days.

10.1212/WNL.0000000000215494
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