Migraine can have a profound impact on people’s lives1,2

More than 30 million adults are living with migraine in the United States1,3,4

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Migraine may affect productivity at work1

  • Nearly 30% of people with migraine reported that their productivity at work was reduced by at least 50% in the previous 3 months in the American Migraine Prevalence and Prevention (AMPP) studya

aThe AMPP study surveyed households to identify people with migraine.1

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Migraine may affect productivity at home1,2

  • 85% of people reported substantial reductions in their ability to do household work or chores due to migraine in a survey of 389 people with migraine living with a household partner as reported in the family impact of migraine study
  • More than one-third of people with migraine reported that household productivity was reduced by at least 50% in the previous 3 months in the AMPP study
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Migraine may affect leisure time and activities2

  • 45% of people reported missing family, social, and leisure activities due to migraine in a survey of 389 people with migraine living with a household partner as reported in the family impact of migraine study
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KEY HIGHLIGHT:

Migraine can lead to reduced productivity and cost people valuable time for work, household tasks, and leisure.1,2



Calcitonin gene-related peptide (CGRP) is thought to play a central role in migraine pathogenesis5

Elevated levels of CGRP can lead to a cascade of vasodilation and pain associated with migraine attacks, as observed in preclinical studies of CGRP5

CGRP, CGRP receptor and blood vessel
  • CGRP, released from the trigeminal ganglia, is elevated during migraine attacks5
  • Perivascular release of CGRP has been shown to induce vasodilation and plasma protein leakage from tissues5
  • An infusion of CGRP can induce migraine attacks in susceptible individuals, and CGRP is involved in the transmission of pain6,7
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ADDITIONAL INFORMATION:

CGRP has also been shown to trigger cluster headache attacks.8
In a study of patients with cluster headache, infusion of CGRP provoked cluster headache attacks during an active cluster period in 8 out of 9 patients with episodic cluster headache.8



American Headache Society (AHS) indications for initiating treatment with CGRP antibodies9

Migraine preventives can only be prescribed by a licensed medical providerb and the patient must be at least 18 years old. Patients must meet the appropriate criteria for one of the conditions listed below9

The AHS recommends initiating treatment with CGRP antibodies for adult patients who experience9:

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Migraine with or without aura (4-7 monthly headache days) and both of the following9:

  • Inability to tolerate at least 2 prior preventive treatments due to side effects OR inadequate response to a 6-week trial of at least 2 prior preventive treatments AND
  • At least moderate patient-reported disabilityc
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Migraine with or without aura (8-14 monthly headache days) and9:

  • Inability to tolerate at least 2 prior preventive treatments due to side effects OR inadequate response to a 6-week trial of at least 2 preventive treatments
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Chronic migraine and either of the following9:

  • Inability to tolerate at least 2 prior preventive treatments due to side effects OR inadequate response to a 6-week trial of at least 2 prior preventive treatments OR
  • Inability to tolerate or inadequate response to a minimum of 2 quarterly injections (6 months) of onabotulinumtoxinA

bDoctor of medicine, doctor of osteopathy, advanced practice provider (DDS [Doctor of Dental Surgery] or DMD [Doctor of Medicine in Dentistry or Doctor of Dental Medicine]).

cDisability can be measured according to the Migraine Disability Assessment (MIDAS) or Headache Impact Test-6 (HIT-6). Moderate disability was considered MIDAS>11 or HIT-6>50.



Migraine questionnaire

Assess the impact of migraine to inform your treatment plan

An impact assessment helps you uncover the burden migraine is placing on your patients’ lives. This understanding can assist you in determining a treatment plan that may be right for your patients.

Download the Migraine Questionnaire to help facilitate a discussion with your patient about migraine.


References: 1. Lipton RB, Bigal ME, Diamond M, et al; for the AMPP Advisory Group. Migraine prevalence, disease burden, and the need for preventive therapy. Neurology. 2007;68:343-349. 2. Lipton RB, Bigal ME, Kolodner K, et al. The family impact of migraine: population-based studies in the USA and UK. Cephalalgia. 2003;23:429-440. 3. Data on File. Lilly USA, LLC. DOF-GZ-US-0028. 4. US Census Bureau. Quick facts. https://www.census.gov/quickfacts/fact/table/US/PST045217. Updated July 1, 2019. Accessed February 19, 2020. 5. Durham PL. CGRP-receptor antagonists—A fresh approach to migraine therapy? N Engl J Med. 2004;350(11):1073-1075. 6. Lassen LH, Haderslev PA, Jacobsen VB, et al. CGRP may play a causative role in migraine. Cephalalgia. 2002;22:54-61. 7. Oku R, Satoh M, Fujii N, et al. Calcitonin gene-related peptide promotes mechanical nociception by potentiating release of substance P from the spinal dorsal horn in rats. Brain Res. 1987;403:350-354. 8. 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. 9. American Headache Society. The American Headache Society position statement on integrating new migraine treatments into clinical practice. Headache. 2019;59:1-18.

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