Galcanezumab

Galcanezumab
Monoclonal antibody
TypeWhole antibody
SourceHumanized
TargetCALCA, CALCB
Names
Trade namesEmgality
Other namesLY2951742, galcanezumab-gnlm
Clinical data
Drug classCGRP antagonist[1]
Main usesMigraines, cluster headaches[1]
Side effectsPain or redness at the site of injection[2]
WHO AWaReUnlinkedWikibase error: ⧼unlinkedwikibase-error-statements-entity-not-set⧽
Pregnancy
category
  • US: N (Not classified yet)
    Routes of
    use    		Subcutaneous injection
    Typical dose120 mg q month[3]
    External links
    AHFS/Drugs.comMonograph
    MedlinePlusa618063
    Legal
    License data
    Legal status
    • US: ℞-only
    • EU: Rx-only
    • In general: ℞ (Prescription only)
    Chemical and physical data
    FormulaC6392H9854N1686O2018S46
    Molar mass144083.69 g·mol−1

    Galcanezumab, sold under the brand name Emgality, is a medication used to prevent migraines and treat cluster headaches.[1] It is given by injection under the skin.[1] Benefits may take up to three months.[1]

    Common side effects include pain or redness at the site of injection.[2] Other side effects may include allergic reactions.[1] Safety in pregnancy is unclear.[1] It is a monoclonal antibody that attaches to and blocks calcitonin gene-related peptide (CGRP), thereby helping blood vessels to return to their normal size.[2]

    Galcanezumab was approved for medical use in the United States and Europe in 2018.[4][2] In the United Kingdom it costs the NHS about £450 per month as of 2021.[3] This amount in the United States is about 580 USD.[5]

    Medical uses

    Dosage

    It is given as an initial dose of 240 mg followed by 120 mg per month.[3]

    History

    In September 2018, galcanezumab was approved in the United States for the preventive treatment of migraine in adults.[4]

    The U.S. Food and Drug Administration (FDA) approved galcanezumab-gnlm based on evidence from three clinical trials (Trial 1/NCT02614183, Trial 2/NCT02614196, and Trial 3/NCT02614261) in 2156 adult patients 18 to 65 years of age with chronic or episodic migraine headaches.[4] Trials were conducted at 318 sites in Asia, Canada, Europe, Israel, Latin America, Puerto Rico, and the United States.[4]

    Trials one and two enrolled patients with a history of episodic migraine headaches.[4] Patients were assigned to receive galcanezumab-gnlm or placebo injections once a month for six months.[4] Neither the patients nor the health care providers knew which treatment was being given until after the trial was completed.[4] The benefit of galcanezumab-gnlm was assessed based on the change from baseline in the number of migraine days per month during the six-month treatment period, comparing patients in the galcanezumab-gnlm and placebo groups.[4]

    Trial three enrolled patients with a history of chronic migraine headaches.[4] Patients were assigned to receive galcanezumab-gnlm or placebo injection once a month for three months.[4] Neither the patients nor the health care providers knew which treatment was being given until after the trial was completed.[4] The benefit of galcanezumab-gnlm was assessed based on the change from baseline in the number of migraine days per month during the three-month treatment period, comparing the galcanezumab-gnlm and placebo groups.[4]

    In November 2018, galcanezumab was approved for use in the European Union for the prophylaxis of migraine in adults who have at least four migraine days per month.[2]

    Galcanezumab was shown to be effective at reducing the number of days participants suffer migraines in three main studies.[2] Overall, galcanezumab led to two fewer days with migraines per month compared with placebo (a dummy treatment).[2] In two studies involving 1,784 participants who had migraines between 4 and 14 days a month, those treated with galcanezumab had four or five fewer days with migraines per month, compared with two to three fewer days for participants on a placebo injection.[2] In a third study of 1,117 participants who had migraines for more than 15 days a month on average (chronic migraine), those treated with galcanezumab had on average around five fewer days with migraines per month compared with around three fewer days for participants on placebo.[2]

    In June 2019, galcanezumab-gnlm was approved in the United States for the treatment of episodic cluster headache in adults.[6]

    The effectiveness of galcanezumab-gnlm for the treatment of episodic cluster headache was demonstrated in a clinical trial that compared the drug to placebo in 106 patients.[6] The trial measured the average number of cluster headaches per week for three weeks and compared the average changes from baseline in the galcanezumab-gnlm and placebo groups.[6] During the three-week period, patients taking galcanezumab-gnlm experienced 8.7 fewer weekly cluster headache attacks than they did at baseline, compared to 5.2 fewer attacks for patients on placebo.[6]

    The application for galcanezumab-gnlm was granted priority review designation and breakthrough therapy designation.[6] The FDA granted the approval of Emgality to Eli Lilly.[6]

    It was third calcitonin gene-related peptide (CGRP) inhibitor approved.[7]

    See also

    References

    1. 1 2 3 4 5 6 7 "Galcanezumab-gnlm Monograph for Professionals". Drugs.com. Archived from the original on 7 December 2019. Retrieved 2 December 2021.
    2. 1 2 3 4 5 6 7 8 9 "Emgality EPAR". European Medicines Agency (EMA). Archived from the original on 22 May 2020. Retrieved 28 April 2020. Public Domain This article incorporates text from this source, which is in the public domain.
    3. 1 2 3 BNF 81: March-September 2021. BMJ Group and the Pharmaceutical Press. 2021. p. 499. ISBN 978-0857114105.
    4. 1 2 3 4 5 6 7 8 9 10 11 12 "Drug Trials Snapshots: Emgality". U.S. Food and Drug Administration (FDA). 23 October 2018. Archived from the original on 7 December 2019. Retrieved 7 December 2019. Public Domain This article incorporates text from this source, which is in the public domain.
    5. ↑ "Emgality Prices, Coupons & Savings Tips - GoodRx". GoodRx. Archived from the original on 20 October 2021. Retrieved 2 December 2021.
    6. 1 2 3 4 5 6 "FDA approves first treatment for episodic cluster headache that reduces the frequency of attacks" (Press release). U.S. Food and Drug Administration (FDA). 4 June 2019. Archived from the original on 7 December 2019. Retrieved 6 June 2019. Public Domain This article incorporates text from this source, which is in the public domain.
    7. ↑ "US FDA approves Lilly migraine drug at a price that is the same as its rivals". CNBC. Reuters. 28 September 2018. Archived from the original on 28 September 2018. Retrieved 29 September 2018.
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