Eptinezumab Real-World: 48% Achieve ≥50% Migraine Reduction at 24 Weeks Including Prior Treatment Failures | Research

The takeaway

Eptinezumab reduced monthly migraine days by 6.9 at 24 weeks with 48.2% achieving ≥50% reduction in a real-world Italian study of 128 migraine patients, most with prior preventive failures.

94% satisfied at 1 year
Nearly all eptinezumab patients reported satisfaction, with 48% achieving ≥50% migraine reduction in a treatment-resistant population

What the researchers found

Eptinezumab: MMD reduction -6.9 at 24 weeks; ≥50% responder: 48.2%; >40% optimal/modest control; early 3-month response predicted 6-month outcome; AEs 4.7%; satisfaction 94% at 12 months.

Why it matters

Real-world evidence for the IV anti-CGRP drug confirms clinical trial efficacy translates to practice, even in treatment-resistant patients.

How the study worked

Prospective multicenter Italian observational study (TACHIS, NCT06409845), 128 migraine patients initiating eptinezumab, 24-week follow-up with MMD, MIDAS, HIT-6, IHS control categories.

What this study cannot tell us

Observational. No control group. Italian population only. 24-week primary follow-up.

How to read the evidence

Prospective multicenter observational study. High-quality real-world evidence.

When this study was published

Published in 2025, NCT06409845.

The bigger picture

Eptinezumab works in real-world patients who have failed other preventives — confirming its role in difficult-to-treat migraine.

Questions still open

How does eptinezumab compare to SC anti-CGRP antibodies in real-world practice?
What predicts super-responder status?
Would quarterly IV dosing improve adherence vs monthly SC injections?

Common questions

How effective is eptinezumab in real life?

In this Italian study of mostly treatment-resistant patients, eptinezumab reduced migraine days by nearly 7/month and nearly half had their migraines cut in half. Satisfaction was 94% at one year.

Is the IV infusion a drawback?

Quarterly IV infusions may actually improve adherence vs monthly self-injections. 94% patient satisfaction suggests the IV format is acceptable to most patients.

Read the original research

Levels of migraine controls following International Headache Society (IHS) recommendations with eptinezumab: Effectiveness and tolerability in a 24-week, prospective multicenter study (the TACHIS study).

Cephalalgia : an international journal of headache, 46(2), 3331024251414659

View on PubMed ↗Publisher’s paper ↗

Citation

Iannone, Luigi Francesco; Piella, Elisa Maria; Montisano, Danilo Antonio; Fasano, Carla; Sebastianelli, Gabriele; Coppola, Gianluca; Ferrandi, Delfina; Lanni, Claudia; Prudenzano, Maria Pia; de Tommaso, Marina; Merlo, Paola; De Cesaris, Francesco; Chiarugi, Alberto; Munafò, Antonio; Pistoia, Francesca; Ornello, Raffaele; Doretti, Alberto; Grazzi, Licia; Lo Castro, Flavia; De Icco, Roberto; Vaghi, Gloria; Avino, Gianluca; Romozzi, Marina; Calabresi, Paolo; Battistini, Stefania; Rufa, Alessandra; Albanese, Maria; Trimboli, Michele; Carlucci, Giovanna; Silvestro, Marcello; Russo, Antonio; Rainero, Innocenzo; Valente, Maria Rosaria; Fofi, Luisa; Marcosano, Marilena; Geppetti, Pierangelo; Altamura, Claudia; Vernieri, Fabrizio; Tassorelli, Cristina; Sacco, Simona; Guerzoni, Simona. (2026). Levels of migraine controls following International Headache Society (IHS) recommendations with eptinezumab: Effectiveness and tolerability in a 24-week, prospective multicenter study (the TACHIS study).. Cephalalgia : an international journal of headache, 46(2), 3331024251414659. https://doi.org/10.1177/03331024251414659