“First FDA-approved drug that reduces the frequency of attacks of episodic cluster headache”

Earlier this month in the USA, the FDA approved Emgality (galcanezumab) for use with episodic cluster headache. This is a big step for CGRP inhibitors, which have shown promise for treating both migraine and cluster (for example, see this article about Ajovy).

As the official Emgality site states:

For adults with episodic cluster headache: Emgality can help reduce the number of weekly cluster headache attacks that occur during a cycle

Emgality.com

As mentioned before, CGRP inhibitors have shown promise for episodic cluster headache treatment, but the treatment of drugs like Emgality is far from a magic cure.

While most of the articles about the recent FDA approval point to the 8.7 fewer attacks per week during a cluster cycle, there is more to the story.

Patients experienced 8.7 fewer attacks, with only 5.2 fewer attacks with placebo. Significant enough to show that Emgality seems to be doing something, but by no means a silver bullet.

But that was in the middle of the trial, which was an 8 week trial. After two months, the difference between Emgality and placebo was even less – a difference which some say “is no longer statistically significant” (see Galcanezumab Offers Help for Cluster Headache and Migraine).

It is good news that cluster patients have something else to try – and we hope that Emgality will help some. But much more needs to be done to help cluster headaches. Sadly, this is only a small step toward better treatment.