TOPLINE:

Patients with migraine who achieved at least a 50% or a 75% reduction in monthly migraine days (MMDs) after their early doses of eptinezumab maintained this response throughout the 72-week treatment period, with sustained response more frequently observed at the 300-mg dose.

METHODOLOGY:

• Researchers conducted a post hoc analysis of a phase 3 clinical trial to assess whether at least 50% or at least 75% reductions in MMDs after early eptinezumab infusions were maintained through 72 weeks of treatment and to evaluate associated long‑term improvements in migraine-related outcomes.
• The analysis included 568 patients aged 18-75 years with migraine who did not respond to two to four previous preventive treatments and received eptinezumab 100 mg (n = 286) or 300 mg (n = 282) every 12 weeks for the entire 72-week treatment period.
• Main outcomes were the maintenance of at least a 50% or at least a 75% migraine response — defined as a reduction from baseline in MMDs — achieved during 1-12 weeks after the first eptinezumab dose or during 1-24 weeks after first and second doses.
• Additional outcomes included the percentage of migraine attacks with severe intensity, the six-item Headache Impact Test (HIT-6) total score, the presenteeism subscore of the migraine-specific Work Productivity and Activity Impairment (WPAI:M) questionnaire, and Patient Global Impression of Change (PGIC) responder rates among early responders during 1-12 weeks.

TAKEAWAY:

• Among patients who achieved at least a 50% migraine response over 1-12 weeks, 61.1% of those treated with eptinezumab 100 mg and 73.8% of those treated with 300 mg maintained this response throughout the 72-week treatment period; when this response was achieved over 1-24 weeks, maintenance was observed in 68.8% and 81.7% of patients, respectively.
• Among patients who achieved at least a 75% migraine response over 1-12 weeks, sustained response was maintained in 34.1% and 62.7% of those treated with eptinezumab 100 and 300 mg, respectively; when this response was achieved over 1-24 weeks, maintenance was observed in 58.3% and 69.5% of patients, respectively.
• In patients with at least a 50% response and at least a 75% response, the mean change in the percentage of migraine attacks with severe pain intensity decreased by approximately 29% with either dose and approximately 35%-39%, respectively, over 1-12 weeks, with improvements sustained through 72 weeks.
• Mean HIT‑6 total scores decreased by 13.3-15.1 points in patients who achieved at least a 50% response over 1-12 weeks and by 13.6-18.1 points in patients who achieved at least a 75% response over 1-12 weeks; WPAI:M presenteeism improved by about two thirds from baseline, and 82%-90% reported being "much improved" or "very much improved" on the PGIC scale by 12 weeks, with these improvements maintained through 72 weeks.

IN PRACTICE:

"The association between first-dose ≥ 50% and ≥ 75% migraine response and improvements in other clinical outcomes — migraine attacks with severe pain intensity, headache-related impact, presenteeism, and overall impression of change in migraine status — highlights the holistic improvements that can be seen with eptinezumab treatment," the authors wrote.

SOURCE:

This study was led by Jessica Ailani, MD, Georgetown University Hospital, Washington, DC. It was published online on March 15, 2026, in the European Journal of Neurology.

LIMITATIONS:

In this analysis, data from participants who received placebo in the randomised, double-blind, placebo-controlled phase were not included. The study did not assess the sequence or pattern of response or non-response across dosing intervals following the initial response period. As the clinical trial was conducted mainly in Europe, the generalisability of the findings to other regions remained limited.

DISCLOSURES:

This study and the clinical trial were funded by H. Lundbeck A/S (Copenhagen, Denmark). Several authors declared serving as consultants or advisory board members, holding editorial or associate editorial roles, or receiving honoraria or research support from various pharmaceutical companies. Some authors reported being full-time employees or holding stocks in H. Lundbeck A/S.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.