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% credible interval (CrI): -3.23 to -1.69) and was more effective than the 100 mg dose (MD = -0.50, 95% confidence interval (CI) = -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.