{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,25]],"date-time":"2026-10-25T08:37:41Z","timestamp":1792917461119,"version":"4.5.0"},"reference-count":41,"publisher":"SAGE Publications","issue":"10","license":[{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Cephalalgia"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>This prospective real-world study aimed to evaluate the effectiveness of escalating eptinezumab to 300\u2005mg in difficult-to-treat migraine patients with a partial response after two 100\u2005mg cycles.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We included adults with high-frequency episodic or chronic migraine who achieved a partial response (30% to &lt;\u200950% reduction in monthly headache days (MHD)) after two 100\u2005mg eptinezumab cycles and escalated to 300\u2005mg for two consecutive quarterly cycles. The primary outcome was the proportion of patients achieving a \u2265\u200950% MHD reduction from baseline after each 300\u2005mg cycle. Secondary outcomes evaluated changes in MHDs with peak intensity &gt;\u20094, monthly acute medication intake, Migraine Disability Assessment (i.e. MIDAS), and Headache Impact Test-6 (i.e. HIT-6) scores. Logistic regression assessed predictors of response.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We analyzed 57 patients (87.7% female, mean\u2009\u00b1\u2009SD age of 48.2\u2009\u00b1\u200910.8\u2005years). Following dose escalation, 57.9% and 64.9% of partial responders achieved \u2265\u200950% MHD reduction after the first and second 300\u2005mg cycles, respectively. Using generalized estimating equations models, estimated marginal mean MHDs (95% confidence interval) dropped from a baseline of 18.65 (16.93\u201320.37) days\/month to 13.33 (11.76\u201314.91) days\/month after two 100\u2005mg cycles, 10.02 (8.15\u201311.88) days\/month after one 300\u2005mg cycle, and 8.84 (6.77\u201310.91)\u00a0days\/month after two 300\u2005mg cycles (all\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.05 vs baseline). Across all secondary outcomes, significant cumulative improvements occurred. Multivariable analysis showed that greater MHD reduction during the 100\u2005mg phase (odds ratio\u2009=\u20090.920,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.008) and no prior erenumab exposure (odds ratio\u2009=\u20090.145,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.012) independently predicted a \u2265\u200950% response.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Escalation to eptinezumab 300\u2005mg was associated with improved population-averaged outcomes in this selected cohort of difficult-to-treat partial responders to 100\u2005mg, supporting, as such, dose escalation over switching therapy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/03331024261498883","type":"journal-article","created":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T12:52:26Z","timestamp":1792587146000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Effectiveness of eptinezumab 300\u2005mg dose escalation in partial responders to 100\u2005mg among patients with difficult-to-treat migraine: A prospective, real-world study by the GRASP study group"],"prefix":"10.1177","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9275-0076","authenticated-orcid":false,"given":"Emmanouil V.","family":"Dermitzakis","sequence":"first","affiliation":[{"name":"General Clinic, Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2131-7114","authenticated-orcid":false,"given":"Andreas A.","family":"Argyriou","sequence":"additional","affiliation":[{"name":"Neurology Department, Headache Outpatient Clinic, Agios Andreas General Hospital of Patras, Patras, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dimitrios","family":"Rikos","sequence":"additional","affiliation":[{"name":"Neurology Department, 404 Military Hospital, Larisa, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Chondrogianni","sequence":"additional","affiliation":[{"name":"Second Department of Neurology, School of Medicine, National and Kapodistrian University of Athens, \u201cAttikon\u201d University Hospital, Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aikaterini","family":"Foska","sequence":"additional","affiliation":[{"name":"Second Department of Neurology, School of Medicine, National and Kapodistrian University of Athens, \u201cAttikon\u201d University Hospital, Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evangelia","family":"Dimitriadou","sequence":"additional","affiliation":[{"name":"Second Department of Neurology, School of Medicine, National and Kapodistrian University of Athens, \u201cAttikon\u201d University Hospital, Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christos","family":"Tsironis","sequence":"additional","affiliation":[{"name":"University Hospital of Ioannina","place":["Greece"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Panagiotis","family":"Soldatos","sequence":"additional","affiliation":[{"name":"Kalamata Headache Clinic, Kalamata, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5563-7776","authenticated-orcid":false,"given":"Anthoula","family":"Tsolaki","sequence":"additional","affiliation":[{"name":"General Clinic, Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emmanouil","family":"Giakoumakis","sequence":"additional","affiliation":[{"name":"NeuroCrete Headache Clinic, Herakleion, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria-Evdokia","family":"Kaligianni","sequence":"additional","affiliation":[{"name":"Irodotos Medical Center, Heraklion, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pantelis","family":"Litsardopoulos","sequence":"additional","affiliation":[{"name":"Neurology Department, Headache Outpatient Clinic, Agios Andreas General Hospital of Patras, Patras, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2715-7898","authenticated-orcid":false,"given":"Michail","family":"Vikelis","sequence":"additional","affiliation":[{"name":"Glyfada Headache Clinic","place":["Greece"]},{"name":"Mediterraneo Hospital Headache Clinic, Glyfada, 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