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PACAP-Targeting Monoclonal Antibody Reduces Monthly Migraine Days in People With Refractory Migraine

02/19/2026

According to results of the intravenous (IV) portion of the phase IIb PROCEED clinical trial (NCT06323928), treatment with bocunebart (Lundbeck, Valby, Denmark) demonstrated a statistically significant reduction in monthly migraine days (MMDs) compared with placebo over 12 weeks in participating adults with migraine and 1 to 4 prior preventive treatment failures in the past 10 years. Bocunebart is an investigational monoclonal antibody targeting the pituitary adenylate cyclase-activating polypeptide (PACAP).

PROCEED is an adaptive, phase 2b dose-finding and route-of-administration trial evaluating bocunebart administered once monthly for 3 months. The IV cohort included 431 patients across 14 countries who met International Classification of Headache Disorders (ICHD-3) criteria for migraine and had documented failure of 1 to 4 preventive therapies within the past 10 years. The primary end point was the mean change from baseline in MMDs over weeks 1 through 12 compared with placebo. The trial also assessed safety and tolerability.

Key findings reported in a statement from Lundbeck include the following:

  • Bocunebart demonstrated a statistically significant difference vs placebo in mean change from baseline in MMDs over weeks 1 to 12
  • Bocunebart was generally well tolerated, and no new safety signals were identified during the trial.

Bocunebart binds and inhibits PACAP signaling, a pathway distinct from calcitonin gene-related peptide (CGRP)–targeted therapies.

Source: H. Lundbeck A/S. Lundbeck announces positive phase IIb top-line results with bocunebart (LuAG09222; anti-PACAP mAb) in migraine prevention. Lundbeck. Published February 12, 2026. Accessed February 17, 2026. https://news.cision.com/h--lundbeck-a-s/r/lundbeck-announces-positive-phase-iib-top-line-results-with-bocunebart--lu-ag09222--anti-pacap-mab--,c4307114

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