Galcanezumab Improves Medication Overuse in Patients With Migraine

PHILADELPHIA—Galcanezumab, a humanized monoclonal antibody that selectively binds to the calcitonin-gene–related peptide, reduces average monthly migraine days and reduces medication overuse among patients with migraine, according to findings presented at the American Headache Society’s 61st Annual Scientific Meeting.

To reach this conclusion, the researchers conducted a post-hoc analysis of the phase 3 EVOLVE-1, EVOLVE-2, and REGAIN trials. All trials included patients with episodic migraine and chronic migraine.

The EVOLVE-1 and -2 trials defined episodic migraine as 4 to 14 monthly migraine days, and the REGAIN trial defined chronic migraine as 15 or more monthly migraine days per month for more than 3 months.

Headache medication overuse was defined using International Classification of Headache Disorders 3rd Edition criteria, and patients self-reported headache medication overuse via electronic diaries.

At baseline in the EVOLVE trials, 169 (19.3) of the placebo group; 74 (17.0%) of the galcanezumab, 120 mg, group; and 82 (19.2%) of the galcanezumab, 240 mg, group had baseline medication overuse.

At baseline in the REGAIN trial, 353 (63.4%) of the placebo group; 178 (64.3%) of the galcanezumab, 120 mg, group; and 177 (64.1%) of the galcanezumab, 240 mg, group had baseline medication overuse.

After analyzing the data, the researchers found that both galcanezumab doses significantly improved patient outcomes.

“Both doses of galcanezumab significantly improved mean monthly [migraine headache days] compared with placebo in patients with baseline medication overuse,” the researchers concluded. “Average monthly medication overuse decreased with galcanezumab compared with placebo in patients with baseline medication overuse. Galcanezumab is at least as efficacious in patients who overuse acute medications as in those who do not.”

—Amanda Balbi

Reference:

Aurora SK, Ruff D, Pearlman EM. Medication overuse in a post-hoc analysis of phase 3 placebo-controlled studies of galcanezumab in the prevention of episodic and chronic migraine. Paper presented at: American Headache Society 61st Annual Scientific Meeting; July 11-14, 2019; Philadelphia, PA.