Eptinezumab-jjmr

(Vyepti®)

Vyepti®

Drug updated on 10/28/2024

Dosage FormInjection (intravenous; 100 mg/mL)
Drug ClassCalcitonin gene-related peptide antagonists
Ongoing and
Completed Studies
ClinicalTrials.gov

Indication

  • Indicated for the preventive treatment of migraine in adults.

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Summary
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  • This summary is based on the review of 16 systematic review(s)/meta-analysis(es). [1-16]
  • Eptinezumab 300 mg significantly reduced monthly migraine days (The mean difference (MD): -2.46, 95% CrI: -3.23 to -1.69) and was more effective than the 100 mg dose (MD = -0.50, 95% CI (confidence interval) = -0.56 to -0.44; p < 0.00001).
  • Responder rates improved with Eptinezumab: ≥75% (and risk ratio (RR) = 1.80, 95% CI: 1.40, 2.33), ≥50% (RR = 1.46, 95% CI: 1.33, 1.61), and 100% (RR = 2.41, 95% CI: 1.08, 5.38) compared to placebo (P < 0.001).
  • Eptinezumab 300 mg outperformed Fremanezumab, Galcanezumab, and Erenumab for reducing monthly headache days, ranking highest with a 0.82 probability in On the Surface Under the Cumulative Ranking Area (SUCRA) analysis. Fremanezumab-monthly was more effective for reducing monthly migraine days (MD: -2.77, 95% CrI: -3.36 to -2.17).
  • Patients with prior treatment failures benefited most from Eptinezumab, showing superior outcomes compared to other related peptides (CGRP) monoclonal antibodies.
  • Eptinezumab did not show a significant increase in treatment-related adverse events (RR = 1.01, 95% CI 0.94–1.10, P = 0.71) or serious adverse events (RR = 0.93, 95% CI 0.46–1.90, P = 0.84) compared to placebo.
  • Nasopharyngitis was the most frequently reported adverse event, mild in severity, and not attributed to the drug. Hypersensitivity reactions occurred in 1.1% of patients but were mild and resolved quickly.
  • Discontinuation due to adverse events was more likely with the 30 mg dose of Eptinezumab (odds ratio (OR) 2.62, 95% CI 1.03–6.66).
  • Eptinezumab demonstrated significant efficacy for patients with chronic migraines and those with prior treatment failures, consistently reducing monthly migraine days and improving response rates across both groups. The 300 mg dosage provided the highest effectiveness compared to lower doses.

Product Monograph / Prescribing Information

Document TitleYearSource
Vyepti (eptinezumab-jjmr) Prescribing Information.2024Lundbeck Seattle BioPharmaceuticals, Inc., Bothell, WA

Systematic Reviews / Meta-Analyses

Document TitleYearSource
Reporting Quality and Risk of Bias Analysis of Published RCTs Assessing Anti-CGRP Monoclonal Antibodies in Migraine Prophylaxis: A Systematic Review2024Journal of Clinical Medicine
Efficacy and safety of eptinezumab 300mg versus 100mg for migraine patients: a meta-analysis of randomized controlled studies2024The International Journal of Neuroscience
Efficacy and safety of eptinezumab for migraine: A systematic review and meta-analysis2023Journal of Research in Medical Sciences
Clinical effectiveness of pharmacological interventions for managing chronic migraine in adults: a systematic review and network meta-analysis2023The Journal of Headache and Pain
Competing treatments for migraine: a headache for decision-makers2023The Journal of Headache and Pain
Comparison of indirect treatment methods in migraine prevention to address differences in mode of administration2023Journal of Comparative Effectiveness Research
Evaluating the efficacy of CGRP mAbs and gepants for the preventive treatment of migraine: A systematic review and network meta-analysis of phase 3 randomised controlled trials2023Cephalalgia
Safety and tolerability of monoclonal antibodies targeting the CGRP pathway and gepants in migraine prevention: A systematic review and network meta-analysis2023Cephalalgia
Efficacy and safety of monoclonal antibody against calcitonin gene-related peptide or its receptor for migraine patients with prior preventive treatment failure: a network meta-analysis2022The Journal of Headache and Pain
European Headache Federation guideline on the use of monoclonal antibodies targeting the calcitonin gene related peptide pathway for migraine prevention - 2022 update2022The Journal of Headache and Pain
Comparative Effectiveness and Tolerability of the Pharmacology of Monoclonal Antibodies Targeting the Calcitonin Gene-Related Peptide and Its Receptor for the Prevention of Chronic Migraine: a Network Meta-analysis of Randomized Controlled Trials2021Neurotherapeutics
Efficacy and safety of anti-calcitonin gene-related peptide monoclonal antibodies for treatment of chronic migraine: A systematic review and network meta-analysis2021Clinical Neurology and Neurosurgery
Indirect Comparison of Topiramate and Monoclonal Antibodies Against CGRP or Its Receptor for the Prophylaxis of Episodic Migraine: A Systematic Review with Meta-Analysis2021CNS Drugs
Efficacy and Safety of Monoclonal Antibody Against Calcitonin Gene-Related Peptide or Its Receptor for Migraine: A Systematic Review and Network Meta-analysis2021Frontiers in Pharmacology
Safety and tolerability of eptinezumab in patients with migraine: a pooled analysis of 5 clinical trials2021The Journal of Headache and Pain
Different dosage regimens of Eptinezumab for the treatment of migraine: a meta-analysis from randomized controlled trials2021The Journal of Headache and Pain

Clinical Practice Guidelines