A new anti-calcitonin gene related peptide antibody therapy has shown efficacy in the preventative treatment of chronic migraine. The medication is distinctive compared to other CGRP antibody therapy in that it is administered by intravenous infusion, and reaches maximum plasma concentration in about 30 minutes, corresponding to the end of the infusion.

The medication is also unique in that a recent study indicates that this infusion therapy may provide benefits within hours of the infusion, with more frequently resolved acute migraine pain compared to placebo.

Patients with migraine have previously had to wait several weeks for the effect of their preventative medications to manifest, often resulting in extended periods of pain and reduced functioning, with potential visits to emergency departments to obtain migraine relief, and risk of overuse of acute medication.

Treatment with the iv infusion more frequently resolved headache pain at 2 hours compared to placebo. Additional studies have shown the magnitude of the benefit observed at day 1 was sustained over the 12 week dosing interval.

The data would suggest therefore that the new intravenous therapy has the potential to address both the acute and preventative treatment needs of patients with migraine. It raised the potential of being both an effective treatment preventing future attacks of migraine, with the added benefit of alleviating an acute migraine attack.

References:

Winner PK, McAlister P, Chakhava G et al Effects of Intravenous Eptinezumab vs Placebo on Headache Pain and most Bothersome Symptom when initiated during a Migraine attack A Randomised clinical trial, JAMA 2021, 325 (23) 2348-2356

Lipton RB, Goadsby PJ, Smith J et al, Efficacy and safety of Eptinezumab in patients with chronic migraine PROMISE-2, Neurology 2020;94:e1365-e1377