Products
Eptinezumab is in the development phase and is not yet commercially available.
Structure and properties
Eptinezumab is an IgG1 monoclonal antibody directed against CGRP.
Effects
Eptinezumab reduces the number of migraine attacks. The effects are due to binding of the antibody to CGRP, the calcitonin gene-related peptide. CGRP is a neuropeptide that plays an important role in triggering migraine attacks. It consists of 37 amino acids and is expressed in the peripheral and central nervous systems. Two isoforms exist, CGRP-α (Figure) and CGRP-β, which differ in three amino acids. Both are agonists at the CGRP receptor. CGRP has potent vasodilatory properties and plays a central role in pain initiation as well as neurogenic inflammation. Migraineurs have been found to have elevated levels of CGRP during an attack, and intravenous administration of the peptide can induce attacks in migraineurs. Triptans, which are administered for the treatment of migraine attacks, also inhibit the release of CGRP.
Indications
For the prevention of migraine attacks.
Dosage
According to the SmPC. The antibody has a long half-life and therefore a long dosing interval. In the studies, eptinezumab was injected intravenously.
Contraindications
For complete precautions, see the drug label.
Adverse effects
The most common possible adverse effects include injection site reactions
