Among adults with migraine who have experienced prior treatment failure, eptinezumab is associated with improved activity impairment, absenteeism, presenteeism, and work productivity loss compared with placebo. These are the findings of a study published in The Journal of Headache and Pain.
Migraine is associated with a reduction in productivity and is estimated to cause losses exceeding $21 billion annually. As migraine greatly impacts society, finding a treatment that reduces productivity loss remains an unmet need.
Researchers conducted a phase 3b, multicenter, randomized, double-blind, placebo-controlled, parallel-group trial (DELIVER; ClinicalTrials.gov Identifier: NCT04418765) at 96 sites in 17 countries and was completed in 2021. Adults (N=890) aged 18-75 years with migraine who had 2 to 4 migraine preventative treatment failures were randomly assigned to receive 100 mg eptinezumab (n=299), 300 mg eptinezumab (n=293), or placebo (n=298) intravenously every 12 weeks for 24 weeks. Eptinezumab is a humanized monoclonal antibody that targets calcitonin gene-related peptide and is delivered via quarterly infusion.
For this analysis, work- and productivity-related outcomes were evaluated every 4 weeks, using the Work Productivity and Activity Impairment measure of migraine (WPAI:M) questionnaire.
The proportion of individuals who were employed at baseline were 75.2% for low-dose eptinezumab, 78.2% for high-dose eptinezumab, and 79.4% for placebo cohorts.
The number of hours per week worked increased from baseline to week 12 in the low-dose (mean, 31.8 vs 36.2 h) and high-dose (mean, 31.4 vs 35.7 h) eptinezumab cohorts but not among those who received placebo (mean, 32.3 vs 32.3 h).
At baseline, mean absenteeism scores ranged from 11.4% to 12.9%, presenteeism scores from 50.8% to 53.4%, work productivity loss scores from 53.7% to 57.0%, and activity impairment from 58.5% to 59.1%.
At week 4, absenteeism scores improved by 1.6% among individuals who received placebo compared with 6.4% (P <.001) and 7.5% (P <.0001) for individuals in the low- and high-dose eptinezumab groups, respectively. Presenteeism improved by 9.7% compared with 23.1% (P <.0001) and 25.1% (P <.0001), work productivity loss improved by 9.3% compared with 24.8% (P <.0001) and 25.7% (P <.0001), and activity impairment improved by 10.1% compared with 22.0% (P <.0001) and 23.3% (P <.0001) for individuals in the placebo group compared with those in the low- and high-dose eptinezumab groups, respectively.
At week 24, compared with placebo, individuals who received eptinezumab continued to report significantly better absenteeism (P <.01), presenteeism (P <.0001), work productivity (P <.0001), and activity impairment (P <.0001) scores.
Stratified by episodic or chronic migraine subtypes, the effects of eptinezumab tended to be larger among patients with episodic migraine.
In a correlation analysis, presenteeism was correlated with work productivity loss (r range, 0.45-0.48), absenteeism was correlated with patient-identified most bothersome symptom (PI-MBS) and monthly migraine days (MMD; r range, 0.27-0.29), and activity impairment with PI-MBS and MMD (r range, 0.39-0.48).
This study was limited by the fact that not all patients completed MPAI:M evaluations at each follow-up.
These data indicated that eptinezumab dosed at 100 or 300 mg and administered every 12 weeks associated with improvement to work- and productivity-related outcomes among patients with migraine who have experienced prior treatment failure.
“… [E]ptinezumab treatment, and anti-CGRP therapies in general, can improve patient work productivity and ultimately quality of life,” the researchers concluded.
Disclosure: Multiple authors declared affiliations with industry. Please refer to the original article for a full list of disclosures.
Barbanti P, Goadsby PJ, Lambru G, et al. Effects of eptinezumab on self‑reported work productivity in adults with migraine and prior preventive treatment failure in the randomized, double‑blind, placebo‑controlled DELIVER study. J Headache Pain. Published online December 2, 2022. doi:10.1186/s10194-022-01521-w