PO-43 | Eptinezumab in migraine patients unresponsive to prior subcutaneous CGRP(-R) monoclonal antibody treatment: a retrospective case series
Abstract
Background: In real-world studies, anti-CGRP(-receptor, -R) monoclonal antibodies (mAbs) have achieved a ≥50% reduction in monthly migraine days (MMDs) in up to 77% of patients. Despite these generally favorable outcomes, up to one-third of patients do not respond to subcutaneous CGRP(-R) mAbs. These patients may benefit from switching to a different CGRP(-R) mAb, with highly variable 30% response rates to these switches. This study aims to evaluate the short-term effectiveness of eptinezumab following a single infusion in patients who had previously failed treatment with a subcutaneous mAb.
Methods: We retrospectively collected data from 13 migraine patients treated at the Headache Centre of Spedali Civili of Brescia. All had previously received subcutaneous mAbs without benefit and were subsequently administered a single intravenous dose of eptinezumab (100 mg). MMDs, days of acute medication use, and migraine pain intensity were recorded using standardized headache diaries at baseline (T0) and after 12 weeks (T3). The Migraine Disability Assessment (MIDAS) questionnaire was also completed at both time points.
Results: Of the 13 patients included (3 males, 10 females), 92% had chronic migraine at baseline, and 69% exhibited medication overuse (triptans and/or NSAIDs). Additionally, 61% had previously received treatment with onabotulinumtoxinA. Nine patients had been treated with erenumab, two with fremanezumab, and two with galcanezumab, each following a washout period of…
How strong is the evidence?
Evidence Hub reads this as a case series, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health. Reported size: 13 participants or records.
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