First successful protocol for desensitization to eptinezumab

Background: Eptinezumab is an anti-calcitonin gene-related peptide monoclonal antibody used for migraine prevention. During clinical trials, hypersensitivity to eptinezumab was described without a clear underlying mechanism. To determine if the reaction was immunoglobulin E-mediated, the team of Nice University Hospital (Nice, France) performed the eptinzeumab skin tests. A 10-step desensitization protocol has been proposed to manage these reactions.

Findings: Two patients presenting with immediate hypersensitivity reactions underwent the eptinezumab skin test. Neither skin test was positive, suggesting a non-immunoglobulin E-mediated mechanism. The patients then completed the desensitization protocol successfully.

Conclusion: This hospital-based 10-step desensitization protocol appears safe and effective.