Migraine treatments: On the horizon

A CGRP therapy is currently filed with the FDA: ALD 403 (eptinezumab) from Lundbeck. In the PROMISE 1 Phase III clinical trial in episodic migraine patients, more than a 50% reduction in the proportion of patients experiencing a migraine on Day 1 post-dose was seen; 1/3 of patients achieved a greater than 75% reduction in migraine days through 4 and 12 weeks. The data demonstrated that patients experienced even further reductions in migraine following the third and fourth quarterly infusions at both dose levels (100mg and 300mg) of eptinezumab.

Estimated sales of CGRP anti migraine drugs suggest that Aimovig (monthly via autoinjector) should hit $917 million annually by 2020 with an estimated peak market share of 38%. Ajovy (monthly or quarterly via pre-filled syringe) should bring in $228 million annually by 2020 with an estimated peak market share of 20%. Emgality (monthly via autoinjector) should earn $296 million annually by 2020 and achieve 24 % estimated peak market share. Finally, Eptinezumab (quarterly via intravenous infusion) is expected to earn $46 million each year by 2020 with a 19% estimated peak market share.

Finally, IntelGenx is developing Rizaport Versafilm (a formulation of rizatriptan) which has EU approval and a Complete Response in the US but which was re-filed with the FDA on 26 September 2019. The advantage of this drug is that since it comes in the form of a thin film which is taken orally, it does not require the patient to take a pill or consume water which can be helpful for migraine suffers who often experience nausea.

Review our previous migraine articles featuring an overview of current treatments, and a summary of the current epidemiology of this condition.