Efficacy and safety of eptinezumab for migraine: A systematic review and meta-analysis

Calcitonin gene-related peptides (CGRP) have been considered a new effective means to prevent and treat migraine. Eptinezumab is a new class of CGRP antagonists that has been ratified for clinical treatment. The purpose of this systematic review was to assess and contrast the therapeutic effect and safety of eptinezumab in the management of migraine in comparison with a placebo.

We systematically searched PubMed, Embase, Cochrane Library, and the US National Institutes of Health Clinical Trials Registry from the earliest date to February 16, 2023, for randomized controlled trials (RCTs). The mean difference (MD) and risk ratio (RR) were chosen to assess clinical indicators.

In total, there were 2, 739 patients in four RCTs, who were ultimately included. Our summarized results showed that eptinezumab had better healing efficacy compared to placebo with respect to monthly migraine days (MD = -1.56, 95% confidence interval [CI]: -2.32, -0.79, P < 0.001), improving ≥75% migraine responder rate (RR = 1.80, 95% CI: 1.40, 2.33, P < 0.001), ≥50% migraine responder rate (RR = 1.46, 95% CI: 1.33, 1.61, P < 0.001), and 100% migraine responder rate (RR = 2.41, 95% CI: 1.08, 5.38, P < 0.001). Furthermore, compared with placebo, there was no significant increase for treatment-related adverse events (RR = 1.01, 95% CI 0.94, 1.10, P = 0.71) and serious AEs (RR = 0.93, 95% CI 0.46, 1.90, P = 0.84). It was found that all dosages except for 10 mg had significant efficacy compared with placebo, especially 300 mg (P < 0.001).

Eptinezumab has good healing efficacy and insignificant adverse effects in treating migraine, particularly the dosage of 300 mg.