PACAP38-induced migraine attacks are independent of CGRP signaling: a randomized controlled trial

Al-Karagholi, Mohammad Al-Mahdi; Zhuang, Zixuan Alice; Beich, Signe; Ashina, Håkan; Ashina, Messoud

doi:10.1186/s10194-025-02022-2

The Journal of Headache and Pain

Table 2 Individual participant outcome data in the eptinezumab group

From: PACAP38-induced migraine attacks are independent of CGRP signaling: a randomized controlled trial

Patient	Peak headache (Duration of headache)	Headache characteristics^a	Associated symptoms^b	Mimics usual migraine	Migraine-like attacks (onset)^c	Treatment (time)/efficacy^{d, e}
*ID: 1* *Female*
Spontaneous		Unilat/8/throb/+	+/+/+
Epti-PACAP-38	7 h (12 h)	Bilat/3/throb and pres/-	+/+/-	Yes	Yes (6 h)	Ibuprofen 600 mg (6 h)/No Paracetamol 500 mg (6 h)/No
*ID: 4* *Female*
Spontaneous		Unilat/8/throb/+	+/+/+
Epti-PACAP-38	2 h 30 min (14 h 40 min)	Right/2/throb and pres/+	+/-/-	No	Yes (2 h 30 min)	Ibuprofen 400 mg (17 h)/No Ibuprofen 400 mg (21 h)/No
*ID: 6* *Female*
Spontaneous		Unilat/6/throb/+	+/+/+
Epti-PACAP-38	4 h 10 min (12 h)	Bilat/4/throb and pres/+	+/+/+	Yes	Yes (2 h 10 min)	Paracetamol 1 g (7 h)/Yes
*ID: 7* *Female*
Spontaneous		Bilat/7/throb/+	+/ + /+
Epti-PACAP-38	7 h (10 h)	Bilat/2/pres/+	+/ - /-	No	No	None
*ID: 9* *Male*
Spontaneous		Unilat/5/pres/+	+/+/+
Epti-PACAP-38	4 h 10 min (8 h)	Left/6/throb/+	+/-/-	Yes	Yes (2 h 10 min)	None
*ID: 12* *Female*
Spontaneous		Unilat/10/throb and pres/+	+/+/+
Epti-PACAP-38	None		-/-/-	No	No	None
*ID: 13* *Female*
Spontaneous		Bilat/7/throb and pres/+	+/+/+
Epti-PACAP-38	3 h 40 min (10 h)	Right/4/throb and pres/+	+/+/+	Yes	Yes (2 h 20 min)	Paracetamol 1 g (9 h)/No Ibuprofen 600 mg (9 h)/No
*ID: 14* *Male*
Spontaneous		Bilat/6/throb/+	+/+/+
Epti-PACAP-38	3 h (2 h)	Diff/4/pres/-	-/-/-	Yes	No	None
*ID: 17* *Male*
Spontaneous		Bilat/5/throb and pres/+	+/+/+
Epti-PACAP-38	2 h 30 min (3 h 20 min)	Diff and right/4/pres/+	-/+/+	Yes	No	None
*ID: 21* *Female*
Spontaneous		Bilat/6/pres/+	+/+/+
Epti-PACAP-38	4 h 50 min (1 h 40 min)	Diff/2/pres/+	+/-/-	No	No	None
*ID: 25* *Male*
Spontaneous		Unilat/4/throb/+	-/+/+
Epti-PACAP-38	2 h 20 min (10 h)	Bilat/4/pres/+	+/+/+	Yes	Yes (2 h 10 min)	None
*ID: 26* *Female*
Spontaneous		Bilat/7/throb and pres/-	+/+/-
Epti-PACAP-38	3 h 20 min (10 h 10 min)	Bilat/4/pres/+	+/+/-	Yes	Yes (5 h)	None
*ID: 28* *Female*
Spontaneous		Unilat/10/throb/+	+/+/+
Epti-PACAP-38	8 h (7 h)	Left/7/throb/+	+/+/+	Yes	Yes (5 h)	Treo (500 mg acetylsalicylic acid and 50 mg caffeine) (8 h)/Yes
*ID: 30* *Female*
Spontaneous		Right/8/pres/-	-/+/+
Epti-PACAP-38	None		-/-/-	No	No	None
*ID: 31* *Male*
Spontaneous		Right/9/throb and pres/+	+/+/+
Epti-PACAP-38	3 h 10 min (7 h)	Bilat/1/throb and pres/-	-/-/-	Yes	No	None
*ID: 34* *Female*
Spontaneous		Left/7/pres/+	+/+/+
Epti-PACAP-38	None		-/-/-
*ID: 35* *Female*
Spontaneous		Unilat/6/throb/+	+/+/+
Epti-PACAP-38	3 h (3 h 40 min)	Diff and right/1/throb/-	-/-/-	Yes	Yes (9 h)	Paracetamol 500 mg (9 h)/No
*ID: 37* *Male*
Spontaneous		Unilat/6/pres/+	-/+/+
Epti-PACAP-38	None		-/-/-			None
*ID: 38* *Female*
Spontaneous		Bilat/5/pres/+	+/+/+
Epti-PACAP-38	6 h (12 h 50 min)	Diff and bilat/5/throb and pres/+	+/+/+	Yes	Yes (6 h)	Paracetamol 1 g (5 h)/No Ibuprofen 600 mg (5 h)/No

Clinical characteristics of spontaneous and provoked headache and associated symptoms in all participants with migraine without aura in the eptinezumab group.
h: hour, min: minutes.
^a Headache Characteristics: Localization, intensity, quality (throbbing or pressing), and aggravation (by coughing in-hospital, by movement out-of-hospital).
^b Associated Symptoms: Nausea, photophobia, or phonophobia.
^c Migraine-like Attacks: Defined per criteria in Methods.
^d Pain Relief: Pain freedom or ≥ 50% reduction in intensity within 2 h.
^e Treo: Combination of acetylsalicylic acid and caffeine.

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ISSN: 1129-2377

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