Kristin Sullivan, MD, PhD, describes migraines as ‘headaches on steroids.’ Pain from a migraine is so intense, it can completely remove an individual from their daily activities. For many patients, common medication is not enough to alleviate their pain as migraines can be debilitating. New treatments, such as Vyepti infusion, are emerging to help alleviate migraine pain.
Eptinezumab, or Vyepti infusion, is an FDA approved treatment for migraine attack prevention. Vyepti is unique as it is an infusion and can be given via IV, with research suggesting it provides relief from chronic and episodic migraines. Patients do not need to be as frequent with their appointments as with other treatments. There are other benefits as well, with evidence suggesting Vyepti has rapid, long lasting relief.
The focus of this document is to discuss necessary and crucial information Vyepti infusion patients should be educated on prior to treatment, including side effects, total costs, with a focus on what is expected during treatment.
What is Vyepti infusion?
Vyepti infusion is a monoclonal antibody to calcitonin gene related peptide, or CGRP. CGRP is a pivotal protein in migraine physiology. CGRP is activated when a migraine begins. It will widen the blood vessels in and around the head and start the blood flowing as if it is trying to relieve a migraine. Blocking CGRP with Vyepti will relieve more frequent and severe migraines.
With Vyepti, people suffering from migraines won’t need to worry as much, as Vyepti only requires one intravenous infusion every 12 weeks, instead of the common daily pills or other alternative that Vyepti infusion therapy offers.
How Vyepti Infusion Therapy Works
- Administration: Infusion therapy with Vyepti takes about 30 minutes, as it is performed intravenously in either a clinic or a specialized infusion clinic.
- Frequency: Patients are statistically shown to receive one infusion every 3 months.
- Dosage: Patients are prescribed 100 mg fill doses, 300 mg doses are much rarer, only prescribed in comparison to the doctor’s suggestions.
- Onset of Relief: While many patients find that improvement is appreciated only after the infusion has been sitting for a few weeks, many patients describe a stark improvement after the infusion.
Benefits of Vyepti Infusion
- Reduced Migraine Frequency: Research now shows that patients who experience migraines daily, can drastically cut the number of migraine days.
- Convenient Dosing: These patients only require 4 infusions for the whole year, as opposed to the patients on daily or bi-monthly treatments.
- Fast-Acting Relief: These patients also enjoy the benefit of rapid relief,, as a few of them exhibit a total change post- infusion.
- Improved Quality of Life: With the decrease in migraine pains, patients also reported improved work productivity, change in the number of workdays missed, and increased general wellness.
- Alternative to Injections: These patients have reported the greatest satisfaction, as they no longer have to self inject or those who have had no success with other preventative treatments.
What Happens During a Vyepti Infusion
Vyepti infusion therapy is usually a straightforward process. It includes the following steps:
- Check-In: You will be welcomed by the clinic or infusion center medical personnel.
- Preparation: You will have a small IV line placed in your arm by a nurse.
- Infusion: For 30 minutes, the infusion is given to you slowly.
- Observation: You will probably be monitored for a little bit to see if you have any side effects.
- Post-Infusion: You can continue your normal activities usually, right after the appointment.
The whole procedure can be completed in a swift manner, causing little disturbance to the patient’s daily schedule and eliminating any major discomfort.
What are the Side Effects from Vyepti Infusion
As with any therapy, Vyepti may cause some discomfort although it is proven that the majority of patients tolerate it. Side effects include, but are not limited to:
- Congestion or nasal drip
- Mild sore throat
- Exhaustion
- Flow from the insertion site (provoked by the insertion of the IV)
To some extent, side effects such as rash, for instance, can, although rarely, include allergic reactions—swelling, breathing difficulties, and the inability to have full control of oneself. If any severe reaction occurs, that requires immediate medical attention.
Why Would One Use Vyepti Infusion Therapy?
Vyepti infusion therapy may be recommended for:
- Migraines (chronic or frequent) with little to no response to oral or injectable medications.
- Low therapy adherence due to minimal treatment options available.
Infusions aren’t ideal for everyone. Some individuals may have specific health concerns like profound hypersensitivity to monoclonal antibodies or other intolerable reactions to fusion therapy.
Cost and Insurance Coverage
Infusions of Vyepti tend to have a significant out of pocket cost without insurance, frequently heading into the thousands for a single session. Regardless, infusions are covered by most health insurance companies if prescribed for the specific purpose of migraine prophylaxis.
Moreover, the pharmacological company that produces Vyepti, Lundbeck, also has a Vyepti Copay Assistance Program, potentially lessening the financial burden for a subset of patients. Insurance and the manufacturer should be the first places patients seek financial aid.
Alternatives to Vyepti Infusion
Other monoclonal antibodies that target CGRP like Aimovig, Ajovy, and Emgality (30-day injections) may also serve as alternatives. Other options are Botox injections to manage chronic migraine, or traditional preventative treatments such as beta blockers, anti seizure medications, or some antidepressants.
Final Thoughts
Aside from traditional medications, Vyepti infusion therapy provides new, innovative, and effective treatment options for migraine sufferers. Most patients have found success with chronic and episodic migraines. Patients appreciate the therapy’s effectiveness, the ease of infusion provided by quarterly infusion therapy, and the mild side effects.
Discuss the therapy with your neurologist or headache specialist to evaluate whether it is appropriate for your migraine therapy plan.
FAQs About Vyepti Infusion Therapy
1. How long does a Vyepti infusion take?
Most patients spend 30 minutes being infused, although some additional time is required for preparation.
2. How soon will I notice results after starting Vyepti?
With Vyepti therapy, some patients report symptom relief within a few days. For others, it may take several weeks or an entire treatment cycle before changes are noted.
3. How often do I need to get Vyepti infusions?
Most patients have an infusion every 3 months.
4. Is Vyepti safe?
Most patients report a high tolerance to Vyepti infusion therapy, although some side effects may be experienced.
5. Is it possible for me to discontinue some of my migraine medications if I start using Vyepti?
It is dependent on what the physician recommends. Some patients may opt for other therapies along with Vyepti until the desired outcome is achieved.
6. Is Vyepti infusion covered by insurance?
It is covered by some insurance plans, but the actual coverage depends on the individual plan. Patients should check with their insurance provider and inquire about what co-pay assistance is available.
7. What should I do if I fail to attend an infusion?
In case of a cancellation, it is important to schedule the appointment for a new date and time as soon as possible. Maintaining the time periods between doses is as important as the total number of doses for the outcome.
