Eptinezumab for Migraine Prevention in Patients with 2-4 Prior Treatment Failures: DELIVER Subpopulation Analysis

Abstract text (incl. figure legends and references)

OBJECTIVE: In DELIVER, eptinezumab reduced migraine frequency in patients with episodic (EM) or chronic migraine (CM) and 2-4 documented prior preventive treatment failures versus placebo. This analysis evaluated the preventive migraine efficacy of eptinezumab in specific subgroups of patients.

METHODS: DELIVER (NCT04418765) randomized patients to eptinezumab 100mg, 300mg, or placebo (administered intravenously every 12 weeks). Change from baseline in monthly migraine days (MMDs) over Weeks 1-12 was analyzed in patient subgroups, including sex, disease classification, medication-overuse headache (MOH) diagnosis, and number of previous treatment failures.

RESULTS: Eptinezumab-treated patients demonstrated greater MMD reductions over Weeks 1-12 than placebo across all subgroups, with larger numerical advantages in patients with MOH versus the general population, CM versus EM, high-frequency versus low-frequency EM, and >2 prior preventive treatment failures versus 2 prior failures. The 95% confidence intervals for mean differences from placebo in change from baseline did not cross 0 for any subgroups except men and patients with low-frequency EM (both had ≤40 patients per treatment arm).

CONCLUSIONS: Across all explored subgroups of adults with migraine and prior preventive treatment failures, greater reductions in MMDs over Weeks 1-12 were observed with eptinezumab versus placebo in patients with MOH, CM, and >2 documented prior treatment failures.