Vyepti (eptinezumab-jjmr) / Teva, Lundbeck - LARVOL DELTA

A retrospective audit of the real-world safety and effectiveness profile of eptinezumab for treatment-resistant chronic migraine in Australia. (PubMed, Headache) - "Our findings show that eptinezumab is a safe, well-tolerated migraine prophylactic that decreases monthly migraine and headache days in a small sample of Australian patients with treatment-resistant chronic migraine. Further prospective studies with larger sample sizes and longer follow-up data are needed to confirm findings of this study."

Journal • Real-world evidence • Retrospective data • CNS Disorders • Migraine • Pain

2025 guideline update to acute treatment of migraine for adults in the emergency department: The American Headache Society evidence assessment of parenteral pharmacotherapies. (PubMed, Headache) - "Prochlorperazine IV and GONB must be offered to eligible adults presenting to the ED with a migraine attack for treatment of headache requiring parenteral therapy (level A - must offer) in those without contraindications, while hydromorphone IV must not be offered (level A - must not offer). Treatments that should be offered when appropriate (level B - should offer) include dexketoprofen IV, ketorolac IV, metoclopramide IV, sumatriptan SC, and SONB. Chlorpromazine IV, dexamethasone IV, and valproate IV may be offered (level C - may offer). Paracetamol IV may not be offered (level C - should not offer). Eptinezumab should be offered (level B) only for patients matching the clinical trial population but is rated level U - no recommendation for an ED-specific population. Additional evidence is needed for caffeine, granisetron, ibuprofen, ketamine, lidocaine, normal saline, propofol, and SPG blocks, all currently rated level U - no recommendation."

Journal • CNS Disorders • Migraine • Pain

MIGRA-MS: A case series on chronic migraine and multiple sclerosis (EHF-EHC 2025) - "Prior treatments included interferons and glatiramer acetate; current therapies consisted of ocrelizumab, natalizumab, alemtuzumab, teriflunomide, or dimethyl fumarate...All received a median of three classic preventives (amitriptyline in all cases) and onabotulinumtoxinA (PREEMPT, 155 IU) with only one responder; two patients received an extended dose (195 IU) without benefit and later CGRP monoclonal antibodies (galcanezumab, erenumab, eptinezumab) with no response, and atogepant with only transient or partial benefit...In this case series of relapsing–remitting MS with chronic resistant migraine, response to onabotulinumtoxinA and anti-CGRP therapies was limited, with no drug interactions or adverse effects observed. An individualized approach and further studies are needed to assess emerging treatments in this subgroup."

Clinical • CNS Disorders • Migraine • Multiple Sclerosis • Pain

Migraine worsening after excellent initial response to galcanezumab (EHF-EHC 2025) - "Several prophylactics were tried (topiramate, amitriptyline, and atogepant) with no improvement...However, in the last few months of treatment, she experienced recrudescence of symptoms – she's now awaiting treatment with eptinezumab...While he tried several preventive medications (topiramate, amitriptyline, venlafaxine and valproic acid), he was also medicated with corticosteroids...Recent literature and medical experience refer to Galcanezumab as a good sustained treatment to refractory migraine. However, these cases highlight the situations in which, despite the initial response being great, there's no prolonged effect on pain relief."

Cardiovascular • CNS Disorders • Complement-mediated Rare Disorders • Hepatology • Hereditary Angioedema • Migraine • Pain

People with migraine and two years treatment with anti-CGRP therapies. First results from the prospective national registry "Hercules" (EHF-EHC 2025) - "So far, 322 subjects with migraine and prior failure to at least 3 repurposed anti-migraine prophylactic treatments attending 7 headache centers in Greece have been recorded, of whom 141 (43.7%) completed the 2-year treatment with anti-CGRP agents [17/141 (12%) subjects with erenumab; 18/141 (12.7%) with galcanezumab; and 106/141 (75.2%) with fremanezumab] while 51/322 (15.8%) participants discontinued treatment [fremanezumab 26/322 (8%); galcanezumab 17/322 (5.3%); 7/322 (2.2%) erenumab; eptinezumab 1/322 (0.3%)], due to failure [40/322 (12.4%)], adverse events (AE) [9/322 (2.8%)], or complete remission of migraine [2/51 (0.6%)]. More than 75% or 100% reduction in MMDs were recorderd in 38/141 (26.9%) and 9/141 (6.4%) subjects. Anti-CGRP mAbs are effective, safe, and well tolerated after long-term administration and should be considered as a first-line prophylactic treatment for migraine."

Clinical • CNS Disorders • Constipation • Gastroenterology • Gastrointestinal Disorder • Migraine • Pain

Satisfaction rates and self-reported adverse events of antiCGRP therapies for migraine prevention – Focus on patient perspectives (EHF-EHC 2025) - "4% of questionnaires corresponded to patients on Atogepant, 9.3% on Erenumab , 24.4% on Eptinezumab, 29% on Galcanezumab and 32% on Fremanezumab. Most frequent, were gastrointestinal symptoms and local skin reactions. Nevertheless, some other complaints were not expected such as weight gain, dizziness, palpitations and chest pain arising in more than 10% of patients, showing the need for maintaning recent therapies adverse events surveillance"

Adverse events • Clinical • Cardiovascular • CNS Disorders • Hypertension • Migraine • Pain

Response to Eptinezumab in a real-world setting – A 24 month experience in a Portuguese hospital (EHF-EHC 2025) - "It improved even very difficult migraine patients and reversed analgesic overuse in all patients. After 12 months of therapy improvement continued to be seen, stressing the importance to maintain therapy on the long run."

Clinical • Real-world • Real-world evidence • CNS Disorders • Migraine

Real-world effectiveness of eptinezumab in participants in whom ≥1 prior anti-cgrp preventive treatment had failed: Results for the first 75 participants in an ongoing prospective study (EHF-EHC 2025) - "The mean MHD reduction was 5.8 days/month ( P <0.001; baseline: 19.0 MHDs) on MIDAS; a MIDAS-derived 50% reduction in MHDs was achieved by 42% (95% CI: 29%–56%) of participants; and an increase of 5.3 good days/month was reported ( P <0.001; baseline: 10.0 days/month). Participants for whom prior anti-CGRP therapies have failed experienced, on average, improvements across multiple participant-reported migraine outcomes after escalation to eptinezumab treatment."

Clinical • Real-world • Real-world effectiveness • Real-world evidence • CNS Disorders • Migraine

Therapeutic challenges in a rare trigeminal autonomic cephalalgia (EHF-EHC 2025) - "A discrete improvement was noted with intravenous eptinezumab 300 mg every 12 weeks, in combination with duloxetine, gabapentin, topiramate and tapentadol. He makes excessive use of fast-acting tramadol and ibuprofen to alleviate acute pain...SUNCT remains a therapeutic challenge due to its rarity, limited evidence base, and frequent refractoriness. This reinforces the need for further research and therapeutic innovation."

Rheumatology

Eptinezumab 100 mg infusion every one or two months in the prevention of severe chronic migraine : A faisability study in a French headache centre (EHF-EHC 2025) - "Administering 100mg of eptinezumab every 4to8 weeks appears to be a relevant alternative for patients who are partial or non responders to the quartely regimen. Recognition of this practice in France could support its broader implementation, allow for controlled studies"

CNS Disorders • Migraine • Pain

Local cutaneous complications of CGRP monoclonal antibodies: A case series (EHF-EHC 2025) - "Nine women treated with subcutaneous anti-CGRP monoclonal antibodies developed mild/moderate local cutaneous reactions (mainly erythema, induration, edema, and pruritus) representing 5% of all treated patients (n=190; fremanezumab 88, galcanezumab 75, erenumab 27)...Two continued therapy with supportive measures (local cooling, topical corticosteroid cream, pre/post-injection antihistamines, and rotation of injection site to abdominal area), while five required switching due to persistent reactions with or without lack of efficacy: two to atogepant, one to erenumab then eptinezumab, and one directly to eptinezumab; one discontinued...Supportive measures allowed continuation in some cases, but most required switching to another monoclonal antibody or a gepant. Monitoring and proactive management are essential to minimize treatment discontinuation."

Clinical • CNS Disorders • Dermatology • Immunology • Migraine • Pruritus

Efficacy of eptinezumab during a migraine attack: Preliminary data from an Italian multicenter real-world experience (the BEFREE study) (EHF-EHC 2025) - "Pain freedom was reported by 6.5% of patients at T10, 20% T20, 13.3% T30, 16.7% 1h, 19% 2h, 58% 12h, 35.3% 24 h and 31.3% 48 h. The achievement of pain freedom from T10 to T20 and from 4h to 12h was significant (p=0.046). During the first 30 minutes of the infusion, eptinezumab demonstrated to induce a rapid resolution of migraine pain intensity and associated symptoms, suggesting a peripheral site of pharmacological action for CGRP blockade."

Clinical • Real-world • Real-world evidence • CNS Disorders • Migraine • Pain

Eptinezumab and onabotulinumtoxinA in the treatment of chronic migraine: A real-world evidence study (EHF-EHC 2025) - "Frontiers in pharmacology. 2023;14:1296577."

Clinical • HEOR • Real-world • Real-world evidence • CNS Disorders • Migraine • Pain

Eptinezumab for migraine prevention: Initial experience from a Portuguese tertiary hospital (EHF-EHC 2025) - "Prior anti-CGRP monoclonal antibody use was documented in 14 patients (78%), all of whom had previously received galcanezumab. Among them, 4 were also treated with fremanezumab, and 1 of these had additionally received erenumab...Nonetheless, in this cohort, it was not frequently selected as a first-line option, being primarily used in patients with highly refractory migraine. Treatment adherence was high and further data are needed to assess long-term effectiveness and better define its role in clinical practice."

Clinical • CNS Disorders • Migraine • Pain

H. Lundbeck A/S – VYEPTI®: Advancing migraine prevention through early intentional IV therapy (EHF-EHC 2025) - "This session will explore how 100% bioavailability and rapid onset differentiate VYEPTI® from other anti-CGRP therapies. Real-world evidence and clinical trial data will be presented to examine the potential impact of earlier use of VYEPTI® in the treatment pathway on patient outcomes and disease course."

CNS Disorders • Migraine • Pain

Reporting of lack of efficacy of anti-CGRP monoclonal antibodies in migraine patients treated with other concomitant monoclonal antibodies: A VigiBase disproportionality analysis (EHF-EHC 2025) - "Reports listing erenumab, galcanezumab, fremanezumab, or eptinezumab as suspected or interacting drugs and collected in VigiBase up to March 9th, 2025 were included and classified as cases (reporting lack of efficacy) or non-cases (reporting other adverse drug reactions). The concomitant use of other mAbs in patients receiving anti-CGRP mAbs for migraine is not associated with increased reporting of lack of efficacy in VigiBase. These findings offer preliminary reassurance regarding the real-world effectiveness of anti-CGRP mAbs when administered in combinations with mAbs for other indications."

Clinical • CNS Disorders • Migraine • Pain

Eptinezumab reduced patient-reported disease burden in patients with chronic migraine and medication-overuse headache: 24-week results from the RESOLUTION trial (EHF-EHC 2025) - P4 | "In participants with CM and MOH who also received patient education, eptinezumab resulted in greater improvements than placebo at Weeks 4 and 12 across ePROs. Similar improvements were seen in both groups at Week 24 after open-label eptinezumab treatment."

Clinical • CNS Disorders • Depression • Migraine • Mood Disorders • Pain

Combining anti-CGRP antibodies with atogepant: Safety and efficacy in a patient cohort (EHF-EHC 2025) - "Treatments included erenumab (n=1), fremanezumab (n=11), galcanezumab (n=6), and eptinezumab (n=9). No serious adverse events were reported. In this real-world cohort, combining anti-CGRP mAbs with atogepant appears to be safe and may offer additional benefit."

Clinical • CNS Disorders • Constipation • Gastroenterology • Gastrointestinal Disorder • Insomnia • Migraine • Sleep Disorder

An observational prospective study assessing the effectiveness of eptinezumab as a preventive treatment for migraine in a real-world setting in Spain: Interim results from the RELEASE study (EHF-EHC 2025) - "Six-month data for participants achieving this milestone will be presented in the poster. This early analysis showed the effectiveness of eptinezumab for migraine prevention in a real-world setting in Spain."

Clinical • Observational data • Real-world • Real-world evidence • CNS Disorders • Migraine • Pain

Eptinezumab improved patient-reported disease burden and quality of life in a predominantly Asian population with chronic migraine: Secondary results from the SUNRISE trial (EHF-EHC 2025) - P3 | "Starting from the first post-baseline assessment (Week 4), eptinezumab 100mg and 300mg were associated with greater improvements from baseline vs placebo across patient-reported outcome scores: PGIC, PI-MBS, HIT-6, MSQ v2.1 domains, and EQ-5D-5L VAS ( p vs placebo were generally sustained at Week 12. Eptinezumab treatment was associated with greater improvements than placebo in headache-related life impact, overall disease status, and HRQoL in a predominantly Asian population with chronic migraine, with improvements across patient-reported outcomes seen as early as Week 4 and generally sustained at Week 12."

Clinical • HEOR • CNS Disorders • Migraine • Pain

Use of eptinezumab or an alternative subcutaneous CGRP-targeting monoclonal antibody after non-response to two prior CGRP targeting treatments: A real-world observational evaluation (EHF-EHC 2025) - "We identified 43 patients who had received a third CGRP-MAb after non-response to 2 prior CGRP targeting treatments; 22 received a third SC MAb (11 galcanezumab, 10 fremanezumab and 1 erenumab) and 21 received eptinezumab. Use of a third SC MAb did not result in a significant reduction in HDs/SHDs, with lower overall positive response rates. Our evaluation is limited by its uncontrolled, observational nature."

Clinical • Real-world • Real-world evidence • CNS Disorders • Migraine

Effectiveness of eptinezumab in patients with migraine and previous preventive anti-CGRP treatment failures: A real clinical practice study in the Valencian community (EHF-EHC 2025) - "Triptan use decreased from baseline to 6 months (72.0% and 19.5% of patients, respectively). This study shows the effectiveness of eptinezumab as a preventive treatment of migraine in a real-world setting in Spain."

Clinical • CNS Disorders • Migraine • Pain

Achievement of 100% migraine response following eptinezumab treatment in adults with migraine: Post hoc analyses across 3 clinical trials (EHF-EHC 2025) - P3 | "In people with CM and those for whom 2–4 prior preventive treatments failed, migraine freedom was observed in greater proportions of participants treated with EPTI than PBO. These proportions increased over long-term EPTI treatment, highlighting the build-up effect of continuous treatment."

Clinical • Retrospective data • CNS Disorders • Migraine • Pain

Middle meningeal artery lidocaine infusion for refractory migraine: First case report in Portugal (EHF-EHC 2025) - "Various pharmacologic classes were tried without benefit: antihypertensives and calcium channel blockers (propranolol, candesartan, flunarizine), antiepileptics (valproic acid, topiramate, oxcarbazepine), antidepressants (amitriptyline, nortriptyline, venlafaxine, fluvoxamine, sertraline, clomipramine), other preventives (prednisolone, oxitriptan, melatonin), cycles of botulinum toxin (PREEMPT protocol), monoclonal antibodies (galcanezumab, fremanezumab, erenumab), and atogepant. At the time of the procedure, the patient was on eptinezumab 100 mg and botulinum toxin every three months but continued to have daily headaches, with severe intensity and reliance on eletriptan for acute relief...It constitutes an invasive therapeutic approach that should be considered only as a rescue option for carefully selected patients with severely refractory migraine. Further studies and long-term follow-up are needed to assess efficacy and safety."

Case report • Clinical • Anorexia • CNS Disorders • Migraine • Pain

Use of eptinezumab or an alternative subcutaneous CGRP-targeting monoclonal antibody after non-response to two prior CGRP targeting treatments: a real-world observational evaluation (EHF-EHC 2025) - No abstract available

Clinical • Real-world • Real-world evidence