EAN 2025 | The effectiveness of eptinezumab in chronic migraine and medication-overuse headache: RESOLUTION

The RESOLUTION study is about medication overuse and in chronic migraine. So it’s a dual diagnosis of chronic migraine and medication overuse. And we want to see whether the CGRP antibody, eptinezumab, has an effect there, an additional effect on brief intervention. And brief intervention is information to the patient about the risk of medication overuse, headache, and overuse of simple analgesic triptans, and in rare cases, opioids. And it can aggravate episodic migraine and it can also aggravate other types of headache, both primary and secondary. But here we focused on chronic migraine. And so all the patients, our hypothesis was that a CGRP antibody had an additional effect on medication overuse and on chronic migraine. So the design was that all the patients that were included had to fulfill a list of inclusion criteria and we excluded those that had opioid overuse because they’re very difficult to work with. But all of them had a short intervention, what’s called brief intervention, has been very successful in general practice and published in Norwegian studies for medication overuse. This group here is a more difficult one from clinics. So we had a multicenter study that was designed and they had all the brief intervention first about risk of medication overuse and then were randomized either to a placebo, saline infusion or to eptinezumab. So, and then we followed them over time and we wanted to see whether there was an early effect, one to four weeks and also one to 12 weeks. Because usually it’s last 12 weeks, the treatment with eptinezumab. So, and then we followed a lot of patient-related outcomes as well and use of medication. But the primary outcome was monthly migraine days and monthly headache days to see whether they went down. And it was a multicenter study. Many places, a few sites in the U.S., mainly in Europe. So the completion rate was very high. 98% and the outcome, the primary outcome, monthly headache and migraine days, was met that it was more effective with eptinezumab than placebo. So that was very positive for the patient and also for the whole treatment strategy and also almost all the secondary outcomes were also more positive in favor of eptinezumab as early as possible. So that was really positive for the patient because they take the analgesics for a reason. It’s their headache. And then they take it more and more frequently. It can aggravate the headache. So now we have a treatment we can give them at an early stage instead of waiting until the medication is completely withdrawn. That was what we used in previous days. In recent years, we give them a dual. We take the acute medication off and give them a prophylactic. But now we can maybe, with a brief intervention that is easy to do and to talk to the patient, also start the preventive treatment as early as possible. Reducing the burden of the headache and reducing the risk of overuse.

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