Conference Coverage

Eptinezumab Improved Migraine-Related Cognitive Symptoms at 6 Months in INFUSE

Edited by:
Anthony Calabro, MA

Key Highlights

  • INFUSE is an ongoing prospective cohort study evaluating real-world effectiveness of eptinezumab for preventive migraine treatment in adults for whom at least 1 prior anti-CGRP preventive treatment had failed.
  • At baseline, migraine-related cognitive symptoms were common and bothersome, with 92.0% of patients reporting brain fog and 86.7% reporting difficulty with tasks.
  • At Month 6, after 2 eptinezumab infusions, 57.8% of patients with baseline brain fog reported improvement.
  • Improvement was also reported in difficulty making decisions, difficulty reading, and difficulty with tasks among at least 50% of patients at Month 6.

An interim analysis of the ongoing INFUSE study presented at the 2026 American Academy of Neurology Annual Meeting in Chicago, IL, found that eptinezumab treatment was associated with patient-reported improvements in migraine-related cognitive symptoms among adults with migraine for whom at least 1 prior anti-calcitonin gene-related peptide preventive treatment had failed.

The analysis focused on migraine-related cognitive symptoms, including brain fog, difficulty making decisions, difficulty reading, and difficulty with tasks. According to the investigators, these symptoms were highly prevalent and bothersome at baseline, and cognitive functioning improved following eptinezumab treatment in at least half of patients across assessed domains at Month 6.

INFUSE is a prospective cohort study designed to evaluate the real-world effectiveness of eptinezumab for preventive migraine treatment in adults with prior preventive calcitonin gene-related peptide treatment failure. Patient-reported outcomes were collected through a web-based platform.

This interim analysis included patients who received 2 infusions of eptinezumab, completed baseline and Month 6 surveys, and reported brain fog or other cognitive symptoms at baseline. The investigators assessed baseline prevalence and bother associated with migraine-related cognitive symptoms and changes in these symptoms through 6 months of treatment.

Study Findings

Among 75 patients with available baseline data, most reported brain fog, defined as difficulty concentrating or focusing, trouble finding the right words or speaking, or mental cloudiness. Brain fog was reported by 92.0% of patients, while 73.3% reported difficulty making decisions, 81.3% reported difficulty reading, and 86.7% reported difficulty with tasks.

These symptoms were frequently described as moderately to extremely bothersome. Brain fog was moderately to extremely bothersome for 84.0% of patients. Difficulty making decisions was moderately to extremely bothersome for 65.3%, difficulty reading for 58.7%, and difficulty with tasks for 65.3%.

In the interim effectiveness population of 48 patients, 57.8% of those with brain fog at baseline reported improvement at Month 6 after 2 eptinezumab doses. Improvement included symptoms rated as minimally improved, much improved, or very much improved.

Among patients with difficulty making decisions at baseline, 50.0% reported improvement at Month 6. Improvement was also reported by 50.0% of patients with difficulty reading and 51.2% of those with difficulty with tasks. The investigators also reported that marked improvements occurred at Day 7.

Clinical Implications

According to the study authors, the findings suggest that cognitive functioning improved following eptinezumab treatment in at least 50% of patients at Month 6, with measurable improvements observed in all assessed domains within 7 days.

Reference
Estemalik E, Lipton R, Soni-Brahmbhatt S, et al. Real-world improvements in cognitive symptoms after eptinezumab treatment in patients in whom ≥1 prior anti-CGRP preventive treatment had failed: 6-month results for the ongoing INFUSE study. Presented at: American Academy of Neurology Annual Meeting; April 2026; Chicago, IL. https://www.aan.com/events/annual-meeting/abstracts#subnav.