How is Vyepti different from Aimovig?

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Accepted Answer

Vyepti is different from Aimovig in that Vyepti is given as an infusion every 3 months whereas Aimovig is a subcutaneous injection given once a month, they are both used for migraine prevention in adults.
Vyepti and Aimovig are both Calcitonin Gene-Related Peptide (CGRP) monoclonal antibodies inhibitors. Vyepti works as a CGRP ligand antagonist and Aimovig works as a CGRP receptor antagonist.

How well does Vyepti work compared to Aimovig?

These figures are from individual drug clinical trials and not from comparison trials. In the individual clinical trials the drug is compared to a placebo.

Decrease in chronic migraine days:

Patients on Aimovig (erenumab) 70mg had a bigger decrease in chronic migraine days per month of 2.5 days (compared to placebo) whereas patients on Vyepti (eptinezumab) 100mg had a decrease of chronic migraine days per month of 2.0 days (compared to placebo).
However at the higher doses Vyepti 300mg had a bigger decrease of migraine days per month of 2.6 days and Aimovig 140mg decreased migraine days per month by 2.5 days.

Patients who had Chronic migraines reduced by half

18.2% of Vyepti 100mg patients had their migraines reduced by half which was more than Aimovig 70mg which was 16.4%. Vyepti 300mg was also more effective at reducing the number of migraines by half at 22.1% whereas in clinical studies 17.7% of Aimovig 140mg patients had their migraines reduced by half.

Decrease in days of episodic migraine headache days

Patient on Aimovig 70mg had 1 day less episodic migraine headache days per month compared to placebo, the patients on Vyepti 100mg had 0.7 less episodic migraine headache days per month compared to placebo and Vyepti 300mg had 1.1 days less episodic migraine headache days.

Patients who had episodic migraines reduced by half

In the Aimovig study 10.2% of patients on Aimovig 70mg had their episodic migraines reduce by half when compared to placebo, the Vyepti study showed that more patients had their episodic migraines decreased by half with 18.3% patients on Vyepti 100mg and 22.1% of the Vyepti 300mg when compared to placebo

How do the side effects of Aimovig and Vyepti compare?

Vyepti 300mg had 3.4% patients (compared to placebo) with side effects of runny nose, sneezing and irritated throat, which was more than Aimovig 140mg that only had 1% of patients with these side effects.
On the lower dose Aimovig 70mg and Vyepti 100mg, patients on both drugs had less runny nose, sneezing and irritated throats than patients taking placebo.
1.2% more Aimovig 140mg patients had sinusitis as a side effect compared to the placebo group, whereas the Vyepti 300mg patients had 1.5% less sinusitis than the placebo patients.
When compared to the placebo group constipation affected 0.3% more patients on Aimovig 70mg and 2.1% more patients on Aimovig 140mg, Vyepti does not list constipation as a side effect.

Table of Aimovig and Vyepti

Aimovig (erenumab-aooe) Vyepti (eptinezumab-jjmr) Indications for use Preventive treatment of migraine in adults Preventive treatment of migraine in adults FDA approval date May 17, 2018 February 21, 2020 Form Subcutaneous injection:
Single-dose prefilled SureClick® autoinjector Single-dose prefilled syringe Intravenous infusion Dose 70mg or 140mg injection once a month 100mg or 300mg infusion every 3 months Half life 28 days 27 days Effectiveness Preventing Chronic Migraine:(Decrease in days monthly migraine headache days compared to placebo -2.5 days Aimovig 70mg
-2.5 days
Aimovig 140mg -2 days Vyepti 100mg:
-2.6 days Vyepti 300mg Effectiveness Preventing Chronic Migraine: (Percentage of patients who had their migraines reduced by half or greater compared to placebo) 16.4% Aimovig 70mg
17.7% Aimovig 140mg 18.3% Vyepti 100mg
22.1% Vyepti 300mg Effectiveness for Episodic Migraine: Decrease in days of episodic migraine headache days per month -1.0 days Aimovig 70mg -0.7 days Vyepti 100mg
-1.1 days Vyepti 300mg Effectiveness Preventing Episodic Migraine: (Percentage of patients who had their episodic migraines reduced by half or greater compared to placebo) 10.2% Aimovig 70mg 18.3% Vyepti 100mg
22.1% Vyepti 300mg Side effects
(if + then drug has more side effects than placebo, if - then drug has less side effects than placebo) Nasopharyngitis:
Aimovig 70mg -0.1%
Aimovig 140mg 1%
Upper respiratory tract infection:
Aimovig 70mg 1.1%
Aimovig 140mg -0.9%%
Sinusitis:
Aimovig 70mg 0%
Aimovig 140mg 1.2%
Fatigue:
Aimovig 70mg -0.6%
Aimovig 140mg -0.3%
Nausea:
Aimovig 70mg 0.3%
Aimovig 140mg 0%
Urinary tract infection:
Aimovig 70mg -0.6%
Aimovig 140mg 0%
Constipation:
Aimovig 70mg 0.3%
Aimovig 140mg 2.1% Nasopharyngitis:
Vyepti 100mg -0.7%,
Vyepti 300mg 3.4%
Upper respiratory tract infection: Vyepti 100mg -1.3%,
Vyepti 300mg -0.1%.
Sinusitis:
Vyepti 100mg -2.1%,
Vyepti 300mg -1.5%
Fatigue:
Vyepti 100mg 0.3%,
Vyepti 300mg -0.2%
Nausea:
Vyepti 100mg -0.2%
Vyepti 300mg 1.5%
Urinary tract infection:
Vyepti 100mg 0.6%
Vyepti 300mg 1.8 Allergen: latex Aimovig prefilled autoinjector contains latex in needle shield within the white or orange cap.
Aimovig prefilled syringe contains latex in gray needle cap Not present

Bottom line:

Aimovig is a subcutaneous injection given monthly to prevent migraines, compared to Vyepti which is an intravenous infusion given 3 monthly to prevent migraines.
Aimovig reduced chronic monthly migraine days by 2.5 days for Aimovig 70mg and 140mg whereas Vyepti 100mg reduced migraine by 2 days and Vyepti 300mg was more effective as it decreased monthly migraine days by 2.6 days.
At 3 months Vyepti 100mg was more effective than Aimovig 70mg at reducing patients chronic migraines by half. At the higher dose Vyepti 300mg had more patients had their migraines reduced by half than Aimovig 140mg.
The most common side effect that affected Vyepti patients was runny nose, sneezing and irritated throat and the most common side effect the affected Aimovig patients was constipation.

How is Vyepti different from Aimovig?

How well does Vyepti work compared to Aimovig?

How do the side effects of Aimovig and Vyepti compare?

Table of Aimovig and Vyepti

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	Aimovig (erenumab-aooe)	Vyepti (eptinezumab-jjmr)
Indications for use	Preventive treatment of migraine in adults	Preventive treatment of migraine in adults
FDA approval date	May 17, 2018	February 21, 2020
Form	Subcutaneous injection: Single-dose prefilled SureClick® autoinjector Single-dose prefilled syringe	Intravenous infusion
Dose	70mg or 140mg injection once a month	100mg or 300mg infusion every 3 months
Half life	28 days	27 days
Effectiveness Preventing Chronic Migraine:(Decrease in days monthly migraine headache days compared to placebo	-2.5 days Aimovig 70mg -2.5 days Aimovig 140mg	-2 days Vyepti 100mg: -2.6 days Vyepti 300mg
Effectiveness Preventing Chronic Migraine: (Percentage of patients who had their migraines reduced by half or greater compared to placebo)	16.4% Aimovig 70mg 17.7% Aimovig 140mg	18.3% Vyepti 100mg 22.1% Vyepti 300mg
Effectiveness for Episodic Migraine: Decrease in days of episodic migraine headache days per month	-1.0 days Aimovig 70mg	-0.7 days Vyepti 100mg -1.1 days Vyepti 300mg
Effectiveness Preventing Episodic Migraine: (Percentage of patients who had their episodic migraines reduced by half or greater compared to placebo)	10.2% Aimovig 70mg	18.3% Vyepti 100mg 22.1% Vyepti 300mg
Side effects (if + then drug has more side effects than placebo, if - then drug has less side effects than placebo)	Nasopharyngitis: Aimovig 70mg -0.1% Aimovig 140mg 1% Upper respiratory tract infection: Aimovig 70mg 1.1% Aimovig 140mg -0.9%% Sinusitis: Aimovig 70mg 0% Aimovig 140mg 1.2% Fatigue: Aimovig 70mg -0.6% Aimovig 140mg -0.3% Nausea: Aimovig 70mg 0.3% Aimovig 140mg 0% Urinary tract infection: Aimovig 70mg -0.6% Aimovig 140mg 0% Constipation: Aimovig 70mg 0.3% Aimovig 140mg 2.1%	Nasopharyngitis: Vyepti 100mg -0.7%, Vyepti 300mg 3.4% Upper respiratory tract infection: Vyepti 100mg -1.3%, Vyepti 300mg -0.1%. Sinusitis: Vyepti 100mg -2.1%, Vyepti 300mg -1.5% Fatigue: Vyepti 100mg 0.3%, Vyepti 300mg -0.2% Nausea: Vyepti 100mg -0.2% Vyepti 300mg 1.5% Urinary tract infection: Vyepti 100mg 0.6% Vyepti 300mg 1.8
Allergen: latex	Aimovig prefilled autoinjector contains latex in needle shield within the white or orange cap. Aimovig prefilled syringe contains latex in gray needle cap	Not present