Does intravenous eptinezumab help reduce pain and symptoms during an ongoing chronic migraine attack?
Eptinezumab is an intravenous medication approved for preventing migraine, but it may also help when given during an ongoing attack. A real-world study found that people with chronic migraine who received eptinezumab during an attack experienced reduced pain and fewer associated symptoms like light and sound sensitivity within minutes 2. This suggests eptinezumab can work quickly to relieve an acute attack, not just prevent future ones.
What the research says
A 2024 real-world study (BE-FREE) enrolled 31 people with migraine, 68% of whom had chronic migraine, who were experiencing an ongoing attack. They received eptinezumab within 1-12 hours of attack onset. Pain scores on a 0-10 scale significantly dropped within 10 minutes of starting the infusion, and further decreased at 20 minutes 2. Sensitivity to light (photophobia) was less common at 10 minutes, and sensitivity to sound (phonophobia) at 20 minutes 2. This indicates eptinezumab can rapidly reduce both pain and migraine-associated symptoms during an attack.
Other research supports eptinezumab's fast action. The RELIEF trial showed that eptinezumab reduced headache pain and associated symptoms within 2 hours of administration when given during a migraine attack 6. In the PROMISE-2 trial, people with chronic migraine and medication-overuse headache who received eptinezumab had fewer migraine days and reduced attack severity 7. A network meta-analysis of phase 3 trials confirmed that eptinezumab is effective for preventing migraine, including in chronic migraine 5.
It is important to note that eptinezumab is primarily approved for migraine prevention, not as an acute treatment. However, the evidence shows it can provide rapid relief when given during an attack, making it a potentially valuable option for people with chronic migraine who need both prevention and acute management.
What to ask your doctor
- Could eptinezumab be an option for me if I often have migraine attacks that don't respond to my current acute medications?
- How quickly might I feel relief if eptinezumab is given during an ongoing attack?
- Are there any risks or side effects of using eptinezumab for acute treatment?
- Would eptinezumab be covered by my insurance if used for acute attacks, or is it only approved for prevention?
- How does eptinezumab compare to other CGRP-targeting treatments for both prevention and acute relief?
This question is drawn from common patient questions about Neurology and answered using cited medical research. We do not provide individualized advice.