Abstract Details

Title Network Meta-analysis of Eptinezumab and Erenumab in Chronic Migraine with Medication overuse Headaches (MOH)

Topic Headache

Presentation(s) P10 - Poster Session 10 (8:00 AM-9:00 AM)

Poster/Presentation
Number 15-005

Objective To compare the efficacy and safety of different doses of anti-CGRP monoclonal antibodies (Eptinezumab and Erenumab) in chronic migraine patients with medication overuse headache using a network meta-analysis.

Background CGRP-targeting monoclonal antibodies are effective for chronic migraine, but data on dose-specific efficacy and safety in patients with medication overuse headache (MOH) are limited.

Design/Methods

We systematically searched PubMed, EMBASE, SCOPUS, and Web of Science through September 2025 for randomized controlled trials (RCTs) evaluating eptinezumab and erenumab in patients with chronic migraine and medication overuse headache (MOH). A frequentist network meta-analysis was conducted using the netmeta package in R with a random-effects model (DerSimonian–Laird estimator). Heterogeneity was assessed with I², and inconsistency with design-by-treatment models. Outcomes included ≥50% reduction in monthly migraine days, remission from medication overuse headache at six months, and serious adverse events. Language refinement was assisted by ChatGPT (OpenAI, GPT-5).

Results

Three RCTs including 1,208 participants (769 active treatment, 439 placebo) were analyzed. For ≥50% reduction in monthly migraine days (3 trials, n = 1,203), eptinezumab 100 mg (OR 2.10, 95% CI 1.06–4.20), eptinezumab 300 mg (OR 2.63, 95% CI 1.09–6.32), and erenumab 140 mg (OR 3.60, 95% CI 1.45–8.91) were superior to placebo; erenumab 70 mg was not significant. For remission from medication overuse headache (2 trials, n = 1,013), both eptinezumab doses and erenumab 140 mg were effective; erenumab 70 mg was not. Serious adverse events (3 trials, n = 1,206) did not differ significantly between treatments, with no heterogeneity observed (I² = 0%).

Conclusions Eptinezumab (100 mg and 300 mg) and erenumab 140 mg significantly reduce monthly migraine days and aid remission from medication overuse headache, while erenumab 70 mg shows no significant benefit. All treatments were well tolerated, with no increase in serious adverse events.

Authors/Disclosures
Arkansh Sharma PRESENTER	Mr. Sharma has nothing to disclose.
Vinay Suresh, MBBS	Dr. Suresh has nothing to disclose.
Rishu Raj, MBBS	Mr. Raj has nothing to disclose.
Abhigyan Datta, MD (University of Minnesota)	Dr. Datta has nothing to disclose.
Medhansh Biradar, MBBS	Mr. Biradar has nothing to disclose.
Nithyanandam Allimuthu, MD	Dr. Allimuthu has nothing to disclose.

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