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Emgality ® (galkanezumab)
Denna information är endast avsedd för sjukvårdspersonal verksam i Sverige och som svar på din fråga. Informationen nedan är på engelska
In the phase 3 migraine prevention clinical studies,
patients received vaccines for various indications during double-blind, placebo-controlled and open-label galcanezumab treatment, however
subgroup analyses were not completed in this population.1
Eli Lilly and Company has not evaluated the safety and efficacy of galcanezumab in combination with vaccines.
Based on the mechanism of action and mechanism of elimination of galcanezumab, there is no reason to expect an interaction with the host immune system. 1
The decision to administer a vaccination to a patient prior to, during, or after galcanezumab treatment must be based on the clinical judgment of the prescribing healthcare practitioner after careful consideration of the patient's risk factors as well as the risks and benefits of vaccination.
Vaccines Administered During Phase 3 Migraine Prevention Clinical Trials
Galcanezumab has been studied in phase 3 randomized, double-blind, placebo-controlled studies in adult patients for the prevention of
chronic migraine (REGAIN),4 and
episodic or chronic migraine that has not benefited from 2 to 4 previous migraine prevention medication categories (CONQUER).5
Galcanezumab has also been studied in a phase 3, open-label, 12-month safety study for the prevention of episodic or chronic migraine.6
Vaccine usage was low overall in the phase 3 migraine prevention studies.1 The influenza vaccine was the most commonly administered vaccine during galcanezumab treatment, with reported usage in 1.26% to 2.82% of patients receiving galcanezumab.
Other vaccines administered to at least one galcanezumab-treated patient included
CGRP mAbs Have no Direct Specific Immunomodulatory Effect
Calcitonin gene-related peptide mAbs have been engineered to bind to either the CGRP peptide or receptor with high specificity and minimized interaction with the immune system.7-9
Galcanezumab is a humanized IgG4 mAb that
binds CGRP, thus
preventing its biological activity.10
As such, it is not expected to
inhibit metabolic or induce enzymatic pathways
be metabolized by the cytochrome P450 families of drug-metabolizing enzymes, and
2. Stauffer VL, Dodick DW, Zhang Q, et al. Evaluation of galcanezumab for the prevention of episodic migraine: the EVOLVE-1 randomized clinical trial. JAMA Neurol. 2018;75(9):1080-1088. http://dx.doi.org/10.1001/jamaneurol.2018.1212
3. Skljarevski V, Matharu M, Millen BA, et al. Efficacy and safety of galcanezumab for the prevention of episodic migraine: results of the EVOLVE-2 phase 3 randomized controlled clinical trial. Cephalalgia. 2018;38(8):1442-1454. http://dx.doi.org/10.1177/0333102418779543
4. Detke HC, Goadsby PJ, Wang S, et al. Galcanezumab in chronic migraine: the randomized, double-blind, placebo-controlled REGAIN study. Neurology. 2018;91(24):e2211-e2221. http://dx.doi.org/10.1212/WNL.0000000000006640
5. Mulleners WM, Kim BK, Láinez MJA, et al. Safety and efficacy of galcanezumab in patients for whom previous migraine preventive medication from two to four categories had failed (CONQUER): a multicentre, randomised, double-blind, placebo-controlled, phase 3b trial. Lancet Neurol. 2020;19(10):814-825. http://dx.doi.org/10.1016/S1474-4422(20)30279-9
6. Camporeale A, Kudrow D, Sides R, et al. A phase 3, long-term, open-label safety study of galcanezumab in patients with migraine. BMC Neurol. 2018;18(1):188. http://dx.doi.org/10.1186/s12883-018-1193-2
7. 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
8. 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
9. 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
11. Lobo ED, Hansen RJ, Balthasar JP. Antibody pharmacokinetics and pharmacodynamics. J Pharm Sci. 2004;93(11):2645-2668. https://doi.org/10.1002/jps.20178
CGRP = calcitonin gene-related peptide
IgG4 = immunoglobulin G (subclass) 4
mAb = monoclonal antibody
▼ 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.
Datum fӧr senaste ӧversyn 2021 M01 21