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July 05, 2016; 87 (1) ArticleOpen Access

TEV-48125 for the preventive treatment of chronic migraine

Efficacy at early time points

Marcelo E. Bigal, David W. Dodick, Abouch V. Krymchantowski, Juliana H. VanderPluym, Stewart J. Tepper, Ernesto Aycardi, Pippa S. Loupe, Yuju Ma, Peter J. Goadsby
First published June 8, 2016, DOI: https://doi.org/10.1212/WNL.0000000000002801
Marcelo E. Bigal
From Teva Pharmaceuticals (M.E.B., E.A., P.S.L., Y.M.); Mayo Clinic (D.W.D., J.H.V.P.), Phoenix, AZ; The Headache Center of Rio (A.V.K.); American Headache Society (A.V.K.); Dartmouth Medical School (S.J.T.), Hanover, NH; and NIHR–Wellcome Trust King's Clinical Research Facility (P.J.G.), King's College London, UK.
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David W. Dodick
From Teva Pharmaceuticals (M.E.B., E.A., P.S.L., Y.M.); Mayo Clinic (D.W.D., J.H.V.P.), Phoenix, AZ; The Headache Center of Rio (A.V.K.); American Headache Society (A.V.K.); Dartmouth Medical School (S.J.T.), Hanover, NH; and NIHR–Wellcome Trust King's Clinical Research Facility (P.J.G.), King's College London, UK.
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Abouch V. Krymchantowski
From Teva Pharmaceuticals (M.E.B., E.A., P.S.L., Y.M.); Mayo Clinic (D.W.D., J.H.V.P.), Phoenix, AZ; The Headache Center of Rio (A.V.K.); American Headache Society (A.V.K.); Dartmouth Medical School (S.J.T.), Hanover, NH; and NIHR–Wellcome Trust King's Clinical Research Facility (P.J.G.), King's College London, UK.
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Juliana H. VanderPluym
From Teva Pharmaceuticals (M.E.B., E.A., P.S.L., Y.M.); Mayo Clinic (D.W.D., J.H.V.P.), Phoenix, AZ; The Headache Center of Rio (A.V.K.); American Headache Society (A.V.K.); Dartmouth Medical School (S.J.T.), Hanover, NH; and NIHR–Wellcome Trust King's Clinical Research Facility (P.J.G.), King's College London, UK.
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Stewart J. Tepper
From Teva Pharmaceuticals (M.E.B., E.A., P.S.L., Y.M.); Mayo Clinic (D.W.D., J.H.V.P.), Phoenix, AZ; The Headache Center of Rio (A.V.K.); American Headache Society (A.V.K.); Dartmouth Medical School (S.J.T.), Hanover, NH; and NIHR–Wellcome Trust King's Clinical Research Facility (P.J.G.), King's College London, UK.
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Ernesto Aycardi
From Teva Pharmaceuticals (M.E.B., E.A., P.S.L., Y.M.); Mayo Clinic (D.W.D., J.H.V.P.), Phoenix, AZ; The Headache Center of Rio (A.V.K.); American Headache Society (A.V.K.); Dartmouth Medical School (S.J.T.), Hanover, NH; and NIHR–Wellcome Trust King's Clinical Research Facility (P.J.G.), King's College London, UK.
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Pippa S. Loupe
From Teva Pharmaceuticals (M.E.B., E.A., P.S.L., Y.M.); Mayo Clinic (D.W.D., J.H.V.P.), Phoenix, AZ; The Headache Center of Rio (A.V.K.); American Headache Society (A.V.K.); Dartmouth Medical School (S.J.T.), Hanover, NH; and NIHR–Wellcome Trust King's Clinical Research Facility (P.J.G.), King's College London, UK.
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Yuju Ma
From Teva Pharmaceuticals (M.E.B., E.A., P.S.L., Y.M.); Mayo Clinic (D.W.D., J.H.V.P.), Phoenix, AZ; The Headache Center of Rio (A.V.K.); American Headache Society (A.V.K.); Dartmouth Medical School (S.J.T.), Hanover, NH; and NIHR–Wellcome Trust King's Clinical Research Facility (P.J.G.), King's College London, UK.
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Peter J. Goadsby
From Teva Pharmaceuticals (M.E.B., E.A., P.S.L., Y.M.); Mayo Clinic (D.W.D., J.H.V.P.), Phoenix, AZ; The Headache Center of Rio (A.V.K.); American Headache Society (A.V.K.); Dartmouth Medical School (S.J.T.), Hanover, NH; and NIHR–Wellcome Trust King's Clinical Research Facility (P.J.G.), King's College London, UK.
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Citation
TEV-48125 for the preventive treatment of chronic migraine
Efficacy at early time points
Marcelo E. Bigal, David W. Dodick, Abouch V. Krymchantowski, Juliana H. VanderPluym, Stewart J. Tepper, Ernesto Aycardi, Pippa S. Loupe, Yuju Ma, Peter J. Goadsby
Neurology Jul 2016, 87 (1) 41-48; DOI: 10.1212/WNL.0000000000002801

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Abstract

Objective: To evaluate the onset of efficacy of TEV-48125, a monoclonal antibody against calcitonin gene-related peptide, recently shown to be effective for the preventive treatment of chronic migraine (CM) and high-frequency episodic migraine.

Methods: A randomized placebo-controlled study tested once-monthly injections of TEV-48125 675/225 mg or 900 mg vs placebo. Headache information was captured daily using an electronic headache diary. The primary endpoint was change from baseline in the number of headache hours in month 3. Herein, we assess the efficacy of each dose at earlier time points.

Results: The sample consisted of 261 patients. For headache hours, the 675/225-mg dose separated from placebo on day 7 and the 900-mg dose separated from placebo after 3 days of therapy (p = 0.048 and p = 0.033, respectively). For both the 675/225-mg and 900-mg doses, the improvement was sustained through the second (p = 0.004 and p < 0.001) and third (p = 0.025 and p < 0.001) weeks of therapy and throughout the study (month 3, p = 0.0386 and p = 0.0057). For change in weekly headache days of at least moderate intensity, both doses were superior to placebo at week 2 (p = 0.031 and p = 0.005).

Conclusions: TEV-48125 demonstrated a significant improvement within 1 week of therapy initiation in patients with CM.

Classification of evidence: This study provides Class II evidence that for patients with CM, TEV-48125 significantly decreases the number of headache hours within 3 to 7 days of injection.

GLOSSARY

CGRP=
calcitonin gene-related peptide;
CI=
confidence interval;
CM=
chronic migraine;
LSM=
least square mean;
NNT=
number needed to treat;
TNC=
trigeminal nucleus caudalis

Footnotes

  • Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article. The Article Processing Charge was paid by Teva Pharmaceuticals Industries.

  • Received October 9, 2015.
  • Accepted in final form March 9, 2016.
  • © 2016 American Academy of Neurology

This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License 4.0 (CC BY-NC-ND), which permits downloading and sharing the work provided it is properly cited. The work cannot be changed in any way or used commercially.

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Letters: Rapid online correspondence

  • TEV-48125 for prevention of chronic migraine: Suspension of scientific disbelief
    • Vinod K. Gupta, Physician, Gupta Medical Centre, Migraine-Headache Institute, New Delhidr_vkgupta@yahoo.com
    Submitted September 08, 2016
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