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Background <p>The REVIEW study evaluated the real-world experiences of individuals treated with eptinezumab for chronic migraine (CM) in the outpatient setting. This post hoc analysis explored eptinezumab effectiveness in three participant subgroups: those who had self-reported psychiatric comorbidities, those previously treated with subcutaneous anti-calcitonin gene-related peptide (anti-CGRP) monoclonal antibodies (mAbs) for migraine prevention, or those who had reported ever experiencing symptoms of brain fog.</p> Methods <p>Adults with a CM diagnosis who completed ≥ 2 eptinezumab infusion cycles provided survey responses that included the number of good days (participant-defined) per month before and after initiating eptinezumab, the presence/absence of comorbid psychiatric conditions, the number and type of subcutaneous anti-CGRP mAbs used prior to initiating eptinezumab, and the presence/absence of brain fog (feeling confused, difficulty learning/remembering, or trouble speaking/reading) and its improvement after initiating eptinezumab.</p> Results <p>Among 94 participants, 61 (65%) reported psychiatric comorbidities, and 84 (89%) had previously used a subcutaneous anti-CGRP mAb. Average increase from baseline in participant-reported total number of good days per month after initiating eptinezumab were 9.8 and 10.1 days for those with the presence or absence of psychiatric conditions at baseline, respectively; based on the type of subcutaneous anti-CGRP mAb, average increase from baseline were, 9.2 days (erenumab), 10.6 days (fremanezumab), and 10.0 days (galcanezumab); and based on the number of prior mAbs, 9.9 days (0 prior), 8.9 days (1 prior), 11.7 days (2 prior), and 8.6 days (3 prior). Participants reporting complete/very much improvement in brain fog had an average 15-day increase in the number of good days per month, while in participants that reported brain fog did not improve, there was a 1-day increase.</p> Conclusions <p>This post hoc analysis of REVIEW showed that eptinezumab treatment can provide patient-perceived benefits across a spectrum of individuals with CM, including those with psychiatric comorbidities, in real-world settings. A greater number of good days regardless of number of prior mAb therapy supports the use of eptinezumab earlier for individuals with CM, rather than cycling through multiple anti-CGRP therapies. Furthermore, good days can provide a meaningful and measurable endpoint to assess preventive treatment and is correlated with improvements in brain fog.</p>

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Real-world effectiveness of eptinezumab in chronic migraine—increase in good days in three subgroups: psychiatric comorbidities, prior subcutaneous anti-calcitonin gene-related peptide therapy, and migraine-associated brain fog

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年11月27日

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  • Charles Argoff,
  • Fawad A. Khan,
  • Steven P. Herzog,
  • Ryan M. Smith,
  • Seema Soni-Brahmbhatt,
  • Divya Asher,
  • Susanne F. Awad,
  • S. Wald Grossman,
  • Foram Patel,
  • Dawn C. Buse

摘要

Background

The REVIEW study evaluated the real-world experiences of individuals treated with eptinezumab for chronic migraine (CM) in the outpatient setting. This post hoc analysis explored eptinezumab effectiveness in three participant subgroups: those who had self-reported psychiatric comorbidities, those previously treated with subcutaneous anti-calcitonin gene-related peptide (anti-CGRP) monoclonal antibodies (mAbs) for migraine prevention, or those who had reported ever experiencing symptoms of brain fog.

Methods

Adults with a CM diagnosis who completed ≥ 2 eptinezumab infusion cycles provided survey responses that included the number of good days (participant-defined) per month before and after initiating eptinezumab, the presence/absence of comorbid psychiatric conditions, the number and type of subcutaneous anti-CGRP mAbs used prior to initiating eptinezumab, and the presence/absence of brain fog (feeling confused, difficulty learning/remembering, or trouble speaking/reading) and its improvement after initiating eptinezumab.

Results

Among 94 participants, 61 (65%) reported psychiatric comorbidities, and 84 (89%) had previously used a subcutaneous anti-CGRP mAb. Average increase from baseline in participant-reported total number of good days per month after initiating eptinezumab were 9.8 and 10.1 days for those with the presence or absence of psychiatric conditions at baseline, respectively; based on the type of subcutaneous anti-CGRP mAb, average increase from baseline were, 9.2 days (erenumab), 10.6 days (fremanezumab), and 10.0 days (galcanezumab); and based on the number of prior mAbs, 9.9 days (0 prior), 8.9 days (1 prior), 11.7 days (2 prior), and 8.6 days (3 prior). Participants reporting complete/very much improvement in brain fog had an average 15-day increase in the number of good days per month, while in participants that reported brain fog did not improve, there was a 1-day increase.

Conclusions

This post hoc analysis of REVIEW showed that eptinezumab treatment can provide patient-perceived benefits across a spectrum of individuals with CM, including those with psychiatric comorbidities, in real-world settings. A greater number of good days regardless of number of prior mAb therapy supports the use of eptinezumab earlier for individuals with CM, rather than cycling through multiple anti-CGRP therapies. Furthermore, good days can provide a meaningful and measurable endpoint to assess preventive treatment and is correlated with improvements in brain fog.