Neurológia pre prax 6/2022

Eptinezumab – the new anti-CGRP monoclonal antibody for prophylactic treatment of migraine

Calcitonin gene‑related peptide (CGRP) plays a key role in the pathophysiology of migraine. Eptinezumab is the first intravenous monoclonal antibody targeting the molecule of CGRP which is used for the preventive treatment of migraine. In this paper the pharmacology of eptinezumab and five successful Phase III clinical studies are reviewed. The study PROMISE‑1 evaluates the efficacy, safety and tolerability of eptinezumab in the preventive treatment of episodic migraine, the study PROMISE‑2 is the same in chronic migraine. The study PREVAIL evaluates the long‑term safety, immunogenicity and patient‑reported efficacy with help of standard questionnaires in the period of two years. The study RELIEF evaluates the efficacy of eptinezumab when administered during migraine attack. Finally, the study DELIVER evaluates the efficacy and safety of eptinezumab in the preventive treatment of migraine in patients with two‑to‑four previous preventive treatment failures. The results of these studies show that eptinezumab is effective and well‑tolerated for the preventive treatment of migraine. At the end some practical comments to the treatment with eptinezumab in clinical practice are mentioned.

Keywords: eptinezumab, calcitonin gene -related peptide (CGRP), migraine, anti -CGRP monoclonal antibody, clinical studies, preventive migraine treatment