Infusion Therapy
CGRP Monoclonal Antibody Infusion Therapy (PBS listing approved)
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. We are currently offering access to this therapy in our clinic (private fees apply, please contact our rooms for further information).
The medication is 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.
What to expect for your Infusion:
What is this medicine?
EPTINEZUMAB is used to prevent migraine headaches.
What should I tell my health care provider before I take this medicine?
They need to know if you have any of these conditions:
• An unusual or allergic reaction to Eptinezumab, other medicines, foods, dyes, or preservatives
• Pregnant or trying to get pregnant
• Breast-feeding
How should I use this medicine?
This medicine is for infusion into a vein. It is given by a health care professional in the migraine specialist clinic.
What may interact with this medicine?
Interactions are not expected, so you can continue to take any of your regular medications. If you should have any questions, please contact our clinical team.
What should I let the treating team know of before my infusion?
• If you have had any difficulties with intravenous access (IV) with prior medical procedures
• If you have any known allergies, in particular to antihistamines (for example, Loratadine), Corticosteroids, CGRP medications, adhesive tapes, latex
• If you suffer from severe needle phobia
• If you have pressing commitments on the day of your infusion
What should I watch for while using this medicine?
Your condition will be monitored carefully while you are receiving this medicine.
What side effects may I notice from receiving this medicine?
Side effects that you should report to your doctor or health care professional as soon as possible:
• Allergic reactions like skin rash, itching or hives; swelling of the face, lips, or tongue
Side effects that usually do not require medical attention (report these to your doctor or health care professional if they continue or are bothersome):
• Sore throat
• Eye watering
This list may not describe all possible side effects. This sheet is a summary, if you have questions about this medicine, your doctor will be available to talk to you further at the time of your appointment.
Do I receive a premedication?
Yes, to reduce your risk of an allergic reaction to the medication, premedication with an antihistamine and a corticosteroid is recommended. This will be provided when you arrive for your appointment, prior to your infusion. Please inform staff if you have concerns regarding this.
How long does my infusion take?
You should allow 2 hours for your appointment, from check in, to IV access, review by your Neurologist, administration of the medications, and then observation after the infusion.
What benefits do we offer in our infusion unit?
• You are provided with a private and quiet room with dimmable lights for your comfort.
• A Neurologist is on site during your infusion and will be available for a consultation with you.
• As an inpatient admission is not required, your stay is around half the time compared to a hospital infusion.
• A registered nurse will be solely allocated to you to monitor you during your infusion.
• You will be offered coffee, tea, refreshments, and a warm blanket.
• You are welcome to bring along a family member or friend to keep you company.
What happens if I do have an allergic reaction to the medication?
As noted, you will be monitored carefully whilst you are receiving the infusion. You will be given a medication (antihistamine and a corticosteroid) prior to your infusion to reduce your risk of an allergic reaction. In the event of an allergic reaction the infusion will be ceased, and you will be provided with further medication to treat the reaction. Depending on the medication given, and the severity of the reaction, your next of kin may be contacted to transport you home. In the unlikely event of a severe reaction (anaphylaxis) transfer for a hospital admission overnight for observation will be arranged.
What happens after my infusion?
At the successful completion of your infusion and monitoring period, you will be able to leave the clinic. The staff will be in contact with you after your infusion the next business day, and again in 4 weeks’ time (for first infusions). It is advised that you record your migraine events in a diary and review with your Neurologist to assess your response to the medication in 12 weeks’ time. If you have found the medication beneficial for your condition you may choose to undergo another infusion cycle.
Click here to read Dr Nicole Limberg’s recently published article in the Pain and Therapy Journal
Published online: 22nd June 2023
Click here to watch the recent story on Channel 9 regarding this treatment
31st March 2022
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
