Summary

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• Galcanezumab-gnlm (Emgality) is indicated for the prevention of migraine and the treatment of episodic cluster headaches in adults. It targets and inhibits the action of calcitonin gene-related peptide, a protein implicated in migraine pathophysiology.
• A comprehensive review was conducted on 23 systematic reviews/meta-analyses focusing on the safety and effectiveness of Emgality within migraine and episodic cluster headache treatment contexts.
• Galcanezumab consistently demonstrates significant reductions in monthly migraine days (MMDs) and the frequency of episodic cluster headaches compared to placebo. Doses typically range between 120mg to 240mg subcutaneously.
• When directly compared with other CGRP-targeting monoclonal antibodies such as erenumab, fremanezumab, or eptinezumab, galcanezumab often ranks high for reducing MMDs while maintaining a favorable responder rate over 50%.
• The drug has been found to be well-tolerated with the most common adverse events being injection-site reactions, nasopharyngitis, and upper respiratory tract infections, which are generally of mild to moderate severity. The incidence of serious adverse events is low and comparable to placebo groups.
• Galcanezumab significantly aids in reversing medication overuse status among patients suffering from chronic migraines, highlighting its role in managing this condition effectively.
• Studies suggest superior efficacy even among difficult-to-treat populations who have had prior treatment failures, making it a valuable option for these patients as well.
• As one of the few treatments specifically indicated for episodic cluster headaches, galcanezumab outperforms traditional therapies like verapamil by providing significant relief through a reduction in headache frequency.