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MigraineSeptember 2024Summary reviewed June 2026

What the HOPE Trial Found — Lu AG09222 for Migraine Prevention

Researchers tested Lu AG09222, an antibody targeting a brain protein called PACAP, in adults with migraine who hadn't responded to at least two other preventive treatments. A single infusion reduced migraine days by about 2 more days per month compared to placebo over the first four weeks.

What the trial was testing

The HOPE enrolled 237 patients with migraine. The study was sponsored by H. Lundbeck A/S and tracked outcomes across the full group of patients who matched the trial's eligibility profile.

It was mid-stage testing (phase 2/3). Trials at this stage are designed to produce evidence regulators and physicians can act on — not just observations to follow up later.

What the results showed

People getting the higher dose had 2 fewer migraine days per month than those on placebo.

The New England journal of medicine · 2024 · NCT05133323

These findings — that compared to placebo over 4 weeks with the 750-mg dose — were published in the The New England journal of medicine and represent the headline result of the study.

Researchers tracked outcomes across 237 patients enrolled in the trial. The result was consistent enough across the group that the team felt confident reporting it.

What this means for patients

For patients with migraine, this result changes the calculus on what to ask their care team about. Whether it changes day-to-day care depends on factors like disease subtype, prior treatments, and where the patient is in their care journey.

What you can do now

This was a mid-stage study and Lu AG09222 is not yet FDA-approved for migraine. If you have hard-to-treat migraine, talk to your doctor about currently approved CGRP antibodies or other preventive options, and ask whether there are open trials testing this new PACAP-targeting approach.

Eligibility for the treatments mentioned above depends on specific test results and clinical history. Bring this summary, the trial name, and your most recent labs or pathology report to your next visit.

Open migraine trials