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First successful protocol for desensitization to eptinezumab

Gerard B, Praudel H, Lanteri-Minet M, Van Obberghen E, Rocher-Moreau F, Rousset J, Jacquier U, Leroy S et al.

Headache, 2026

Abstract

BACKGROUND: Eptinezumab is an anti-calcitonin gene-related peptide monoclonal antibody used for migraine prevention. During clinical trials, hypersensitivity to eptinezumab was described without a clear underlying mechanism. To determine if the reaction was immunoglobulin E-mediated, the team of Nice University Hospital (Nice, France) performed the eptinzeumab skin tests. A 10-step desensitization protocol has been proposed to manage these reactions.

FINDINGS: Two patients presenting with immediate hypersensitivity reactions underwent the eptinezumab skin test. Neither skin test was positive, suggesting a non-immunoglobulin E-mediated mechanism. The patients then completed the desensitization protocol successfully.

CONCLUSION: This hospital-based 10-step desensitization protocol appears safe and effective.

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