About cluster headache

Cluster headache is considered one of the most severe primary headache forms1

Cluster headache belongs to the group of primary headache disorders called trigeminal autonomic cephalalgias2

There are 2 types of cluster headache2,3:

Pie chart of percentage of patients with cluster headache by type

aEmgality (galcanezumab-gnlm) is not indicated for the treatment of chronic cluster headache.4

Attacks last 15 to 180 minutes and can occur from once every other day to 8 times per day

It has been shown that patients with episodic cluster headache experience an average of ~2 active cluster periods per year, each lasting an average of ~8 weeks5



Pain and associated symptoms of cluster headache2

Cluster headache is characterized by severe to very severe pain on 1 side of the head2

Pain is felt in the orbital, supraorbital, and/or temporal regions and is accompanied by either or both of the following2:

1. At least 1 of the following symptoms or signs, ipsilateral to the headache:

Conjunctival injection and/or lacrimation with eye icon
Eyelid edema with eye icon
Miosis and/or ptosis with eye icon
Nasal congestion and/or rhinorrhea with nose icon
Forehead and facial sweating with head icon


2. And/or:

A sense of restlessness or agitation with head icon



Calcitonin gene-related peptide (CGRP) is thought to play a key role in cluster headache6,7

Elevated plasma levels of CGRP are exhibited during episodic cluster headache attacks7

  • CGRP, expressed in trigeminal ganglion neurons, is involved with many cluster headache symptoms6,7
  • CGRP levels have been shown to normalize after treatment with sumatriptan and oxygen in patients with cluster headache7

CGRP has been shown to trigger cluster headache attacks6

In a study of patients with cluster headache6:

8 out of 9 patients icon

Infusion of CGRP provoked cluster headache attacks during an active cluster period in 8 out of 9 patients with episodic cluster headache6



View the role CGRP plays in episodic cluster headache

Exploring Cluster Headache video

References: 1. Leone M, Giustiniani A, Cecchini AP. Cluster headache: present and future therapy. Neurol Sci. 2017;38(suppl 1):S45-S50. 2. Headache Classification Committee of the International Headache Society (IHS). The International Classification of Headache Disorders, 3rd edition. Cephalalgia. 2018;38(1):1-211. 3. Hoffman J, May A. Diagnosis, pathophysiology, and management of cluster headache. Lancet Neurol. 2018;17:75-83. 4. Emgality [Prescribing Information]. Indianapolis, IN: Lilly USA, LLC. 5. Lund N, Barloese M, Petersen A, et al. Chronobiology differs between men and women with cluster headache, clinical phenotype does not. Neurology. 2017;88:1069-1076. 6. Vollesen ALH, Snoer A, Beske RP, et al. Effect of infusion of calcitonin gene-related peptide on cluster headache attacks: a randomized clinical trial. JAMA Neurol. 2018;75(10):1187-1197. 7. Goadsby PJ, Edvinsson L. Human in vivo evidence for trigeminovascular activation in cluster headache: neuropeptide changes and effects of acute attacks therapies. Brain. 1994;117:427-434.

Indications and Important Safety Information
Indications

Emgality is a calcitonin gene-related peptide (CGRP) antagonist indicated in adults for the:

  • Preventive treatment of migraine
  • Treatment of episodic cluster headache

Important Safety Information

CONTRAINDICATIONS
Emgality is contraindicated in patients with serious hypersensitivity to galcanezumab-gnlm or to any of the excipients.


WARNINGS AND PRECAUTIONS
Hypersensitivity Reactions
Hypersensitivity reactions, including dyspnea, urticaria, and rash, have occurred with Emgality in clinical studies and the postmarketing setting. Cases of anaphylaxis and angioedema have also been reported in the postmarketing setting. If a serious or severe hypersensitivity reaction occurs, discontinue administration of Emgality and initiate appropriate therapy. Hypersensitivity reactions can occur days after administration and may be prolonged.


ADVERSE REACTIONS
The most common adverse reactions (incidence ≥2% and at least 2% greater than placebo) in Emgality clinical studies were injection site reactions.


Please see Full Prescribing Information, including Patient Information, for Emgality. See Instructions for Use included with the device.


GZ HCP ISI 10DEC2019