Onset of efficacy and duration of response of galcanezumab for the prevention of episodic migraine: a post-hoc analysis.

Authors:
Peter J Goadsby
Peter J Goadsby
University of California
United States
David W Dodick
David W Dodick
Mayo Clinic
United States
James M Martinez
James M Martinez
Baylor College of Medicine
Margaret B Ferguson
Margaret B Ferguson
Eli Lilly and Company
Indianapolis | United States
Tina M Oakes
Tina M Oakes
Eli Lilly and Company
Dr. Qi Zhang, PhD
Dr. Qi Zhang, PhD
Shandong University
Jinan, Shandong | China
Vladimir Skljarevski
Vladimir Skljarevski
Lilly Research Laboratories
Indianapolis | United States
Sheena K Aurora
Sheena K Aurora
Swedish Headache Center

J Neurol Neurosurg Psychiatry 2019 Apr 19. Epub 2019 Apr 19.

Eli Lilly and Company, Indianapolis, Indiana, USA.

Background And Objective: As new migraine prevention treatments are developed, the onset of a preventive effect, how long it is maintained and whether patients initially non-responsive develop clinically meaningful responses with continued treatment can be assessed.

Methods: Analyses were conducted post-hoc of a double-blind, placebo-controlled, phase II-a study in patients with episodic migraine receiving galcanezumab 150 mg or placebo biweekly for 12 weeks ( 13:885, 2014). The number of migraine headache days per week, and onset of efficacy measured as the first week galacanezumab separated from placebo were determined. Patients with ≥50%, ≥75% and 100% reduction in migraine headache days from baseline at months 1, 2 and 3 were calculated and defined as sustained responses. Non-responders (<50% response) at month 1 or 2 who then showed ≥50%, ≥75% and 100% response at later time-points were calculated.

Results: Patients were randomised to galcanezumab (n=107) or placebo (n=110). A significant (p=0.018) change of -0.89±0.11 (galcanezumab) vs -0.53±0.11 (placebo) migraine headache days indicated onset at week 1. Forty-seven per cent of galcanezumab and 25% of placebo patients responding at month 1 maintained response through months 2 and 3. Of non-responders at month 1, 27% on galcanezumab and 20% on placebo responded on months 2 and 3, and 50% of galcanezumab non-responders in months 1 and 2 responded on month 3, vs 24% on placebo.

Conclusions: The onset of efficacy of galcanezumab is within 1 week in a majority of patients, and patients receiving galcanezumab are twice more likely to maintain responses than placebo patients. Early non-responders may respond by month 2 or month 3.

Trial Registration Number: NCT01625988.

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Source
http://jnnp.bmj.com/lookup/doi/10.1136/jnnp-2018-320242
Publisher Site
http://dx.doi.org/10.1136/jnnp-2018-320242DOI Listing
April 2019
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