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Eptinezumab (brand name Vyepti) has shown strong evidence in reducing both headache and migraine days in patients with episodic and chronic migraine. Here's a breakdown of the key findings:

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🧠 Clinical Trial Data

PROMISE‑1 (Episodic Migraine; ~9 MMD baseline)

• Monthly migraine days (MMDs) decreased by:

  • −3.9 days (100 mg dose, p=0.0182), −4.3 days (300 mg, p=0.0001) vs. −3.2 days for placebo over Weeks 1–12 (wchh.onlinelibrary.wiley.com).

• ≥50% responder rate (halving MMDs): 50.2% (30 mg), 49.8% (100 mg), 56.3% (300 mg) vs. 37.4% for placebo (neurology.org).

PROMISE‑2 (Chronic Migraine; ~16 MMD baseline)

• MMDs dropped by −7.7 days (100 mg) and −8.2 days (300 mg) vs. −5.6 days for placebo over Weeks 1–12 (p<0.0001 for both doses) .

• ≥50% responders: 57.6% (100 mg), 61.4% (300 mg) vs. 39.3% placebo (wchh.onlinelibrary.wiley.com).

Real‑World / Retrospective Studies

• In a U.S. observational study of chronic migraine (n=31):

  • Monthly headache days fell from 24.3 → 17.1 after 6 months (−7.2 days average).

  • Monthly migraine days dropped from 17.6 → 9.1 (−8.5 days).

  • 93.5% had chronic migraine before treatment, but only 25.8% after 6 months (bmcneurol.biomedcentral.com).

• In an Italian real-world cohort (n=30):

  • MHDs decreased from 14.23 → 7.48 (p<0.0001) over two infusions.

  • ~83% were responders (≥50% reduction) (journals.sagepub.com).

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📉 Additional Benefits

• Acute medication use dropped by approx. 3–5 days/month (bmcneurol.biomedcentral.com).

• Headache severity and disability (MIDAS/HIT‑6 scores) notably improved across trials and long-term studies (bmcneurol.biomedcentral.com).

• Rapid onset: Signs of effect often appeared immediately or within the first day post-infusion .

• Safety: Well tolerated, with a side-effect profile comparable to placebo—mostly mild events such as nasopharyngitis and hypersensitivity (pubmed.ncbi.nlm.nih.gov).

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🧩 Meta-Analysis Insight

A broader analysis of 4 RCTs including 2,739 patients confirms:

• Significant reductions in MMD across doses (30 mg, 100 mg, 300 mg).

• Improved ≥50% and ≥75% responder rates, particularly with 100–300 mg dosing (pubmed.ncbi.nlm.nih.gov, thejournalofheadacheandpain.biomedcentral.com).

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✨ Summary

• Chronic migraine: ~8 fewer MHDs/month (300 mg); ~8 fewer MMDs/month.

• Episodic migraine: ~4 fewer MMDs/month.

• Response rates: ~60% achieve ≥50% reduction in chronic migraine.

• Onset: Effects apparent within 1–12 weeks.

• Tolerability: Safe, infrequent IV dosing every 12 weeks.

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👉 In summary: Eptinezumab reliably reduces headache and migraine frequency, lessens medication use, and alleviates disability—especially in chronic migraine patients. It's a clinically supported preventive option with demonstrated real-world and trial efficacy.

Would you like details on dosing comparisons, side effects, or how it stacks up against other CGRP treatments?