What does this research mean for the field?

Eptinezumab reduces monthly migraine days by 6.9 days and achieves a ≥50% response rate in nearly half of patients with migraine after 24 weeks of treatment. Novelty: ClaimNovelty.CONFIRMATORY. Consensus alignment: ConsensusAlignment.SUPPORTS_CONSENSUS.

What question did this study set out to answer?

The study aims to assess the effectiveness and tolerability of eptinezumab in migraine management according to IHS guidelines.

February 16, 2026Open Access

Levels of migraine controls following International Headache Society (IHS) recommendations with eptinezumab: Effectiveness and tolerability in a 24-week, prospective multicenter study (the TACHIS study)

Key Points

The study aims to assess the effectiveness and tolerability of eptinezumab in migraine management according to IHS guidelines.
24-week prospective multicenter observational study
Involved adults with episodic or chronic migraine initiating eptinezumab
Primary outcome measures included monthly migraine days (MMDs) and responder rates
Secondary outcomes assessed included medication use and functional disability
Logistic regression analyzed factors influencing response status.
MMDs decreased by 5.7 days at week 12 and 6.9 days at week 24 (p < 0.001)
43.8% and 48.2% achieved a ≥50% response at weeks 12 and 24, respectively
Over 40% of patients reached optimal or modest migraine control
CGRP therapy-naïve patients showed significant improvement
Adverse events were mild and occurred in 4.7% of patients.

Abstract

Aim The TACHIS study (from the ancient Greek adjective “ tachýs ” meaning rapid) aimed to evaluate eptinezumab effectiveness and tolerability in routine clinical practice, integrating patient-reported outcomes and use of International Headache Society (IHS)-endorsed categories of migraine control by treatment. Background Eptinezumab is the only intravenous anti-calcitonin gene related peptide (CGRP) monoclonal antibody (mAb) approved for migraine prevention. While its efficacy has been demonstrated in RCTs, real-world evidence in patients with prior preventive treatment failures is still limited. Methods TACHIS is a prospective, multicenter, observational study conducted in Italy. Adults with episodic or chronic migraine initiating eptinezumab were followed for 24 weeks. Primary outcomes included change from baseline in monthly migraine days (MMDs) and ≥50% responder rate. Secondary outcomes included changes from baseline in acute medication use, Migraine Disability Assessment (MIDAS) and Headache Impact Test-6 (HIT-6) and IHS-defined residual burden categories. Logistic regression identified factors of response status. Results A total of 128 patients were included (82% female; 82% chronic migraine). MMDs decreased overall by 5.7 days (95% CI: −7.2 to −4.3) at week 12 and 6.9 (95% CI: −8.5 to −5.2) at week 24 (p < 0.001). A ≥ 50% response was achieved in 43.8% and 48.2% of patients at weeks 12 and 24, respectively. Over 40% of patients achieved optimal or modest migraine control. CGRP targeted therapy-naïve patients experienced significant greater benefit, though non-naïve patients also improved. Female sex and chronic migraine diagnosis were independently associated with response at 12 weeks. Adverse events were infrequent (4.7%) and mild, with no discontinuations due to safety concerns. Conclusions Eptinezumab demonstrated effectiveness and tolerability in a real-world population of patients with migraine and prior preventive treatment failures. The integration of migraine control metrics provides a comprehensive evaluation of therapeutic impact and supports eptinezumab use in routine care. Trial Registration The TACHIS study was preregistered on clinicaltrial.gov, NCT06409845.

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