Emgality® ▼ (galcanezumab)

This information is intended for UK registered healthcare professionals only as a scientific exchange in response to your search for information. Please refer to the link for full prescribing information: Emgality Summary of Product Characteristics (SmPC)

Emgality® ▼ (galcanezumab): Use in Patients With COVID-19 (Coronavirus Disease 2019)

The use of galcanezumab in patients with COVID-19 has not been studied.

Use of Galcanezumab in Patients With COVID-19

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

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 CGRP mAbs have been engineered to bind to either the CGRP peptide or receptor with high specificity and minimized interaction with the immune system.2-4

Antibodies, also referred to as immunoglobulins, are composed of 2 identical heavy and 2 identical light chains.3 These chains contain variable and constant sections, involved in antigen binding and biological activity, respectively. Five isotypes exist in humans including IgA, IgD, IgE, IgG, and IgM. Therapeutic mAbs are composed of IgG isotypes which are divided into 4 subclasses in order of decreasing serum concentrations including IgG1 to IgG4.4

Therapeutic mAbs are introduced into the host for a specific purpose.3 

Galcanezumab is a humanized IgG4 mAb that

  • binds CGRP, thus

  • preventing its biological activity.5

Infectious Disease Resources

For the most current information regarding the coronavirus, please refer to the WHO website;

WHO Coronavirus disease (COVID-19) outbreak

References

1. World Health Organization. Naming the coronavirus disease (COVID-19) and the virus that causes it. https://www.who.int/emergencies/diseases/novel-coronavirus-2019/technical-guidance/naming-the-coronavirus-disease-(covid-2019)-and-the-virus-that-causes-it. Accessed March 11, 2020.

2. Raffaelli 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

3. Silberstein 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

4. Levin 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

5. Emgality [summary of product characteristics]. Eli Lilly Nederland B.V., The Netherlands.

Glossary

CGRP = calcitonin gene-related peptide

Ig = immunoglobulin

IgA = immunoglobulin A

IgD = immunoglobulin D

IgE = immunoglobulin E

IgG = immunoglobulin G

IgG4 = immunoglobulin G (subclass) 4

IgM = immunoglobulin M

mAb = monoclonal antibody

WHO = World Health Organization

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: March 11, 2020

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