Living with migraines or episodic cluster headaches can be incredibly challenging, impacting quality of life and daily functioning. Emgality (galcanezumab-gnlm) is a medication that is approved by the Food and Drug Administration (FDA) for the prevention of migraine headache and the treatment of episodic cluster headache. Emglality targets calcitonin gene-related peptide (CGRP), a key player in migraines and cluster headaches. Emglaity is one agent in the drug class of monoclonal antibody medications that target against CGRP and its receptor. By binding to CGRP and preventing its interaction with its receptors, Emgality can help to reduce the frequency of migraine attacks and episodic cluster headaches. It is an injectable medication that is administered once a month.
Also, see our blog on Over-The-Counter Migraine Medications
What is Migraine Headache?
Migraines are a severe type of headache. They often involve severe, throbbing pain, usually on one side of the head. Alongside the pain, migraines can bring a range of symptoms, including nausea, vomiting, sensitivity to light and sound, and visual disturbances. Migraine headaches can be triggered by a variety of factors, including stress, hormonal changes, certain foods, and environmental factors.
What is Episodic Cluster Headache?
Episodic cluster headache is a rare condition, affecting 0.1% of the population. These headaches are characterized by severe, throbbing/stabbing pain on one side of the face and head. These headache attacks can last from 15 to 180 minutes, up to 8 times a day, with clusters of attacks lasting for weeks to months (the “cluster period”), followed by a remission period. These are considered one of the most severe types of headaches.
Emgality for Migraine Headache:
Reduced Migraine Days: Studies have shown Emgality to be effective in reducing the frequency of migraine occurrences. Patients treated with Emgality experienced a significant reduction in the number of migraine days per month compared to those receiving a placebo.
Preventative Treatment: Emgality is used as a preventative treatment for migraines, helping to reduce the frequency of attacks over time.
Emgality for Episodic Cluster Headache:
Reduced Cluster Headache Attacks: Emglaity has shown in studies to reduce the total number of episodic cluster headaches. Over a three-week period, patients taking Emgality experienced 8.7 fewer weekly cluster headache attacks than they did at baseline, compared to 5.2 fewer attacks for patients on placebo. Emgality therapy is started at the onset of each cluster period, and then taken monthly until the end of the cluster period.
Considerations for Use:
Prescription Requirement: Emgality is available by prescription only and should be taken under the supervision of a healthcare provider who specializes in headaches, such as a neurologist.
Individualized Treatment: Treatment plans should be tailored to each patient’s specific needs, taking into account factors such as migraine frequency, severity, and response to other treatments. Typically, other medications are attempted to prevent migraines or treat episodic cluster headache before treatment with Emgality is considered.
Side Effects: Emgality is generally well tolerated. The most common side effect is injection site reactions, such as pain, itching, swelling or redness around the area where the medication is injected.
Conclusion:
For individuals living with migraine or episodic cluster headache, Emgality (galcanezumab-gnlm) offers the potential for reduction in the number of headache attacks they experience. This can improve the quality of life for patients suffering from these potentially debilitating conditions. By targeting the underlying cause of these conditions, it provides a treatment option for those who have not responded adequately to other therapies. It is important to work closely with a healthcare provider to develop a personalized treatment plan that meets individual needs.
Resources:
1) EMGALITY (galcanezumab-gnlm) [package insert]. Indianapolis, IN: Eli Lilly and Company; 2019.
2) Wei DY, Yuan Ong JJ, Goadsby PJ. Cluster Headache: Epidemiology, Pathophysiology, Clinical Features, and Diagnosis. Ann Indian Acad Neurol. 2018 Apr;21(Suppl 1):S3-S8. doi: 10.4103/aian.AIAN_349_17. PMID: 29720812; PMCID: PMC5909131.
3) Kandel SA, Mandiga P. Cluster Headache. [Updated 2023 Jul 4]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK544241/
4) https://www.fda.gov/news-events/press-announcements/fda-approves-first-treatment-episodic-cluster-headache-reduces-frequency-attacks#:~:text=Press%20Announcements-,FDA%20approves%20first%20treatment%20for%20episodic%20cluster,reduces%20the%20frequency%20of%20attacks&text=The%20U.S.%20Food%20and%20Drug,episodic%20cluster%20headache%20in%20adults.
