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VYEPTI

What Is Surprising Us About The New CGRP Preventatives?

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Can you believe it? It was in the spring of 2018 that Aimovig (erenumab) was approved in the USA. My! Time flies!

Looking at the research...

Really, all the CGRP related drugs are still extremely new, when it comes to prescription drugs for migraine. Long term trials are still a future hope. And we’re just starting to guess at some trends that we may be seeing from patients.

But what are some of the trends we’re seeing? Let’s take a moment to talk about them, and you can comment if you’ve had a similar of very different experience.

(1) For many, these drugs are working better than expected!

First, the (very) good news. For many patients, these CGRP inhibitors are working better than the clinical trials even led us to believe.

As drug companies rush to market new migraine drugs, we expect to see headlines that use phrases such as “life-changing!”. But in the case of drugs like Avojy and Aimovig, this does seem to be the case with many patients – a very significant improvement in their symptoms.

And these are not always “just any” patient. These are patients who have not had a lot of success with other medications.

So there are good reasons to have a lot of hope that these new drugs will help many more people around the world in the next few years.

(2) Sometimes these drugs are less effective after a while.

This is a biggie. Reports are coming in that, for many patients, the benefits tend to “wear off” after a while.

Will switching to another CGRP preventative help? It’s very possible, and it’s not at all a surprise that you may need to try more than one before you find the right fit.

But this is one that researchers are going to pay a lot of attention to in the next few years. Which patients are having this issue, and why? Will some CGRP preventatives work better than others? Even if they’re not as beneficial as they were in the first few weeks, do they still provide significant benefit? What’s your experience?

(3) Side Effects

Any surprises with side effects? Side effects are not a huge problem for many patients, but it is starting to sound like constipation is an issue for some, especially with Aimovig (and in this case, switching may provide significant benefit). It seems that it may be more likely to make constipation issues worse if you already have a pre-existing condition.

In a recent discussion published in The American Journal of Managed Care, two neurologists pointed out some of the other side effects they’re seeing – “. . . a worsening of Reynaud syndrome, fatigue, hair loss, sexual dysfunction, and in women, some reports of irregular menstrual periods.”

Again, discussing side effects shouldn’t make it sound like patients are running away from these medications in droves because they’re all having major problems. Side effects may be rare, but we have to keep an eye on them because certain patients may be more prone to certain side effects than others.

If you’ve been taking a new preventative, such as Vyepti, Aimovig, Ajovy, or Emgality, how long have you been on it? What has your experience been? Anything you might share could be a help for our community.

Vyepti to fight Migraine – How is it different (and what’s with the name?!)?

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In February, Vyepti was approved in the USA as a new migraine preventative. An application has been submitted for approval in Canada, and the European Union will be next later this year.

VYEPTI

Vyepti (eptinezumab-jjmr) is yet another “anti-CGRP” medication, so it’s important to understand what is unique about it. Of course, as with any class of medications, one may work well for you even when another similar drug does not. And Vyepti does have a specific biological mechanism that is different than the other anti-CGRP drugs.

However, there’s more to it when it comes to Vyepti.

The key difference with Vyepti is the way you take it, and how often. As you may know, other medications in this class that have been approved are given by injection on a monthly basis (Aimovig, Emgality, and Ajovy). Now Ajovy is an exception, in a way, because it can also be taken quarterly (although it may be slightly more effective if taken monthly).

Vyepti, however, is specifically to be taken quarterly (every three months). It’s attractive for many patients that they only need to take a preventative only four times a year – especially those of us who have endured the two-or-three-times-a-day routine for some medications.

Vyepti is unique in that it is given as intravenous (IV). The usual recommended dose is 100mg (although some patients may need 300mg). This amount is diluted, and given via IV over 30 minutes.

This may sound more extreme than an injection, but many patients might prefer an IV given by a doctor to having to do their own injections.

A positive for this drug is that there seem to be few side effects. The most common ones (which weren’t all that common) occurred actually during the IV. A “stuffy nose” was probably the most common issue.

You may wonder, if this drug is taken so occasionally, how long it takes to start working. The good news is that it seems to start working on “day 1”. Clinical trials have shown that Vyepti reduces the number of migraine days per month, even for those with chronic migraine.

To read more, you can visit the official Vyepti site here. Also check out this helpful article: Breaking News: Eptinezumab-jjmr (VYEPTI™) Approved by FDA.

But in closing we have to ask, what’s with the name?? On the Vyepti website, the authors insist on capitalizing the word (VYEPTI – does that stand for something?), although on other sites the writers resist shouting at their readers. And the official logo is all lowercase.

To some, Vyepti may sound like a mysterious furry creature that roams the mountains.

How drugs get their names is a fascinating study. And I would love to hear more about how VYEPTI got its name. Do you know?

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