Long-term treatment with Eptinezumab in special treatment situations: Real world data

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Eptinezumab 100 mg i.v. every 12 weeks produced significant reduction in monthly headache days from 15.5 at baseline to 9.0 by month 7.
Significant decreases were also seen in monthly analgesic days and mean headache intensity (MAD 9.2 to 4.9; MHI 7.0 to 4.9 by month 7).
Benefits occurred in a real world cohort with high prior treatment failure and frequent psychiatric or comorbid pain syndromes.

J Neurol Sci. 2026 Jul 8;489:126092. doi: 10.1016/j.jns.2026.126092. Online ahead of print.

ABSTRACT

BACKGROUND: The neurotransmitter Calcitonin Gene related Peptide (CGRP) is one of the key players driving migraine attacks. Randomized placebo-controlled studies with eptinezumab, a humanized monoclonal IgG₁ antibody directed against CGRP, provided evidence for its migraine prophylactic effects. This study shows real-world data on eptinezumab in patients with episodic (eM) and chronic migraine (cM) investigating 3 to 12 months of treatment duration.

METHODS: Patients were treated with eptinezumab 100 mg i.v. every 12 weeks for up to 12 months. Clinical data and reports of monthly headache days (MHD), monthly analgesic days (MAD), mean monthly headache intensity (MHI) were collected at baseline (BL) and at month 1 to 12 (M1 to M12) of eptinezumab therapy.

RESULTS: 46 patients (mean 46 ± 12.5 years, 37 females) were included (17 eM, 29 cM). 53% with comorbid psychiatric disorder, 45% with additional pain syndromes, 84% failed at least one CGRP (R) mAb, 92% amitriptyline, 82% topiramate, 76% betablockers, 59% onabotulinumtoxin A, 41% flunarizine. Mean MHD dropped significantly after the 1st, 2nd and 3rd eptinezumab infusion (BL 15.5 ± 1.1; M1 12.1 ± 1.3, p ≤ 0.0001; M4 10.1 ± 1.3, p ≤ 0.0003; M7 9.0 ± 1.6; p ≤ 0.007). Mean MAD (BL 9.2 ± 4.3; M7 4.9 ± 2.8, p ≤ 0.038) and mean MHI (BL 7 ± 1.8; M7 4.9 ± 1.9, p < 0.0001) were significantly reduced following eptinezumab.

CONCLUSIONS: Eptinezumab real-world data demonstrate significant effects on monthly headache days, analgesic days and headache intensity in patients with migraine with multiple prophylactic therapy failures and concomitant depression or other pain disorders.

PMID:42442067 | DOI:10.1016/j.jns.2026.126092

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