Emgality ® ▼ (galcanezumab)

This information is intended for UK registered healthcare professionals only as a scientific exchange in response to your search for information.For current prescribing information for all Lilly products, including Summaries of Product Characteristics, Patient Information Leaflets and Instructions for Use, please visit: www.medicines.org.uk (England, Scotland, Wales) or www.emcmedicines.com/en-GB/northernireland/ (Northern Ireland).

Can Emgality® ▼ (galcanezumab) be used in a patient with COVID-19?

The use of galcanezumab in patients with Coronavirus Disease 2019 (COVID-19) has not been studied.

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Use of Galcanezumab in Patients With COVID-19

Coronavirus disease 2019 (COVID-19) is an infectious respiratory disease caused by severe acute respiratory syndrome coronavirus 2, previously referred to as "2019 novel coronavirus."1,2

Eli Lilly and Company has not studied the use of galcanezumab in patients with COVID-19.

Clinicians should use their clinical judgment in determining the most appropriate approach in treating a patient with galcanezumab who has confirmed or suspected COVID-19.

CGRP mAbs Have no Direct Specific Immunomodulatory Effect

The calcitonin gene-related peptide (CGRP) monoclonal antibodies (mAbs) have been engineered to bind to either the CGRP peptide or receptor with

  • high specificity, and
  • minimized interaction with the immune system.3-5

As CGRP is not an immune system target, CGRP mAbs have no direct immunomodulatory effect.5

The use of galcanezumab is not associated with increased risk of infections or immunosuppression, nor are such events identified as important risks in the galcanezumab risk management plan.6

Published Literature Related to Use of CGRP Monoclonal Antibody Therapy in a Patient With COVID-19

There is limited published literature on the management of patients with migraine and COVID-19. Some examples are provided below.

As of the last revision date, the Spanish Society of Neurology's Headache Study Group has published their opinion that the currently available data do not suggest that interruption to standard headache therapies is warranted.7

In an editorial published in Headache, the authors recommend the use of migraine preventive therapies, which include CGRP mAbs, that allow for management of the patient in a telehealth setting.8

In a real-life exploratory study published in Neurologia, the authors observed that the use of anti-CGRP mAbs by patients with migraine

  • may be safe in clinical practice 
  • presented no association with an increased risk of contracting COVID 19, and 
  • was not associated with a worsening disease course or prognosis when diagnosed with COVID-19.9

Infectious Disease Resources

For the most current information regarding the coronavirus, please refer to the World Health Organization (WHO) website:

WHO Coronavirus disease (COVID-19) outbreak

References

1Naming the coronavirus disease (COVID-19) and the virus that causes it. World Health Organization. Accessed October 12, 2022. https://www.who.int/emergencies/diseases/novel-coronavirus-2019/technical-guidance/naming-the-coronavirus-disease-(covid-2019)-and-the-virus-that-causes-it

2Coronavirus disease (COVID-19). World Health Organization. Accessed October 12, 2022. https://www.who.int/health-topics/coronavirus#tab=tab_1

3Raffaelli B, Reuter U. The biology of monoclonal antibodies: focus on calcitonin gene-related peptide for prophylactic migraine therapy. Neurotherapeutics. 2018;15(2):324-335. http://dx.doi.org/10.1007/s13311-018-0622-7

4Silberstein S, Lenz R, Xu C. Therapeutic monoclonal antibodies: what headache specialists need to know. Headache. 2015;55(8):1171-1182. http://dx.doi.org/10.1111/head.12642

5Levin M, Silberstein SD, Gilbert R, et al. Basic considerations for the use of monoclonal antibodies in migraine. Headache. 2018;58(10):1689-1696. http://dx.doi.org/10.1111/head.13439

6Data on file, Eli Lilly and Company and/or one of its subsidiaries.

7Morollón N, Belvís R, De Dios A, et al. Standard headache and neuralgia treatments and SARS-CoV-2: opinion of the Spanish Society of Neurology's Headache Study Group. Neurología. 2020;35(9):628-632. http://dx.doi.org/10.1016/j.nrl.2020.07.007

8Szperka CL, Ailani J, Barmherzig R, et al. Migraine care in the era of COVID-19: clinical pearls and plea to insurers. Headache. 2020;60(5):833-842. http://dx.doi.org/10.1111/head.13810

9Caronna E, José Gallardo V, Alpuente A, et al; Spanish CGRP-COVID Study Group. Safety of anti-CGRP monoclonal antibodies in patients with migraine during the COVID-19 pandemic: present and future implications. Neurologia (Engl Ed). 2021;36(8):611-617. http://dx.doi.org/10.1016/j.nrleng.2021.03.005. 

This medicinal product is subject to additional monitoring. This will allow quick identification of new safety information. Healthcare professionals are asked to report any suspected adverse reactions.

Date of Last Review: 12 October 2022


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