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Abstract Details

Shift in MHDs below the threshold of preventive optimization after eptinezumab treatment in patients with migraine and history of 2–4 preventive migraine treatment failures
Headache
P5 - Poster Session 5 (5:30 PM-6:30 PM)
12-010

To determine the shift in headache frequency categories among eptinezumab-treated patients within the DELIVER clinical trial.

Preventive treatment can be considered optimized when patients reach <4 monthly headache days (MHDs). In the DELIVER trial of patients with migraine (episodic and chronic) and 2–4 prior preventive migraine treatment trials, eptinezumab reduced migraine and headache frequency more than placebo, with reductions sustained during an 18-month open-label treatment period.

Randomized patients received eptinezumab 100 mg (n=299), 300 mg (n=293), or placebo (n=298) over a 24-week, placebo-controlled period, with placebo patients randomized to eptinezumab 100 or 300 mg for a 48-week, dose-blinded extension period. Patients were classified by number of MHDs reported. Headache frequency categories were: 0, 1–3, 4–7, 8–14, and ≥15 MHDs. Every 12-week dosing interval, the percentage of patients within each category was calculated.

Of those initially randomized to eptinezumab in the placebo-controlled period, 0% of patients experienced ≤3 MHDs at baseline per the inclusion criteria, 20% after the first dose (Weeks 1–12), and 44% by study conclusion (Weeks 61–72). The percentage of patients experiencing ≥8 MHDs at baseline decreased from 92% at baseline to 49% after the first dose and to 28% by the last dose. Of those initially randomized to placebo in the placebo-controlled period, 29% experienced ≤3 MHDs after their first eptinezumab dose (Weeks 25–36) and 43% by Weeks 61–72. Of patients with chronic migraine at baseline and randomized to eptinezumab (n=271), 80% experienced ≤14 MHDs by Weeks 61–72.

Eptinezumab treatment led to sustained improvements and downward shifts in MHDs relative to baseline, with many patients reaching preventive treatment optimization (<4 MHDs). Most patients with chronic migraine at baseline no longer met those diagnostic criteria (≥15 MHDs) by the end of the study.

Authors/Disclosures
Amaal J. Starling, MD, FAAN (Mayo Clinic)
PRESENTER
Dr. Starling has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Axsome Therapeutics. Dr. Starling has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Lundbeck. Dr. Starling has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Medscape. Dr. Starling has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Satsuma. Dr. Starling has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Miller Medical. Dr. Starling has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Pfizer. Dr. Starling has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Salvia. Dr. Starling has received personal compensation in the range of $0-$499 for serving as a Consultant for Abbvie. Dr. Starling has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Amneal. Dr. Starling has received personal compensation in the range of $500-$4,999 for serving as a Consultant for eNeura. Dr. Starling has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Woodberry Associates .
Divya Asher Divya Asher has received personal compensation for serving as an employee of Lundbeck. Divya Asher has received personal compensation for serving as an employee of AbbVie.
Susanne Awad (H. Lundbeck A/S) Susanne Awad has received personal compensation for serving as an employee of Lundbeck.
Xin Ying Lee (Lundbeck A/S) No disclosure on file
Peter Goadsby, MD, PhD, FRS (King Abdullah Univeristy of Science and Technology) Dr. Goadsby has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Abbvie. Dr. Goadsby has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Teva Pharmaceuticals. Dr. Goadsby has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Lundbeck. Dr. Goadsby has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Satsuma. Dr. Goadsby has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Pfizer. Dr. Goadsby has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Shiratronics. Dr. Goadsby has received personal compensation in the range of $500-$4,999 for serving as a Consultant for CoolTech LLC. Dr. Goadsby has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Linpharma. Dr. Goadsby has received personal compensation in the range of $500-$4,999 for serving as a Consultant for PureTech Health LLC. Dr. Goadsby has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Kallyope. Dr. Goadsby has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Seaport Therapeutics. Dr. Goadsby has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Dr Reddy's. Dr. Goadsby has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Orion Pharma. Dr. Goadsby has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Ipsen. Dr. Goadsby has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Massachusetts Medical Society. The institution of Dr. Goadsby has received research support from NIHR. Dr. Goadsby has received publishing royalties from a publication relating to health care. Dr. Goadsby has received publishing royalties from a publication relating to health care. Dr. Goadsby has a non-compensated relationship as a Trustee with Migraine Trust that is relevant to AAN interests or activities. Dr. Goadsby has a non-compensated relationship as a Trustee with Organisation for Understanding Cluster Headache (UK) that is relevant to AAN interests or activities.
Bjoern Sperling (H Lundbeck A/S) Bjoern Sperling has received personal compensation for serving as an employee of Lundbeck . Bjoern Sperling has received personal compensation in the range of $10,000-$49,999 for serving as an officer or member of the Board of Directors for Rehaler . Bjoern Sperling has or had stock in Lundbeck .