Eptinezumab Benefit for Chronic Migraine Linked to Patient-Reported Good Days

An improvement of at least 75% in self-rated good days per month serves as a comprehensive and effective outcome for assessing antimigraine medication efficacy in chronic migraine, according to study results presented at the 2025 American Headache Society (AHS) Annual Scientific Meeting, held from June 19-22, in Minneapolis, Minnesota, and virtually.

The traditional threshold for response to migraine treatment has been a 50% or greater reduction in average monthly migraine days. However, newer treatments like the monoclonal antibody eptinezumab may push the boundaries of the traditional threshold.

Researchers from Albany Medical Center and Ochsner Neurosciences Institute in the United States (US) assessed whether patient-defined good days may be a comprehensive proxy to assess the efficacy of migraine treatment.

In this post hoc analysis, the researchers assessed data from the Real-world EVidence and Insights into Experiences With eptinezumab (REVIEW) study, which was a real-world, observational study conducted in the US. Adults (N=92) with chronic migraine self-reported migraine symptoms, brain fog, and quality of life during 2 or more consecutive eptinezumab infusion cycles.

The primary outcome in this analysis was report of a 75% or more improvement in good days per month from baseline.

Most patients (64.1%) reported a 75% or more improvement in the number of good days per month with eptinezumab.

Patients meeting the primary outcome gained 14.5 more good days with eptinezumab, while others gained 1.7 days; moderate to complete brain fog improvement was 76.6% vs 42.3%.

More patients who reported vs did not report the primary outcome agreed that eptinezumab:

• made migraine symptoms less severe (88.1% vs 60.6%),
• made migraine symptoms less frequent (89.8% vs 51.5%),
• reduced the duration of migraine symptoms (78.0% vs 42.4%),
• reduced non-head pain symptoms (78.0% vs 27.3%), and
• provided faster symptom relief (67.8% vs 36.4%).

Similarly, more patients who reported vs did not report the primary outcome agreed that eptinezumab:

• allowed them to plan their life (89.8% vs 36.4%),
• helped them participate in their social life (86.4% vs 39.4%),
• enabled productivity in daily activities (84.7% vs 39.4%),
• helped them return to responsibilities faster after a migraine attack (72.9% vs 39.4%), and
• increased their confidence in overall well-being (78.0% vs 18.2%).

“[T]hese analyses further support the use of good days/month as an indicator of the comprehensiveness and effectiveness of migraine preventive treatment,” the researchers concluded.

Disclosure: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.