Meta-analysis: erenumab is not associated with vascular adverse events

  • Kudrow D & al.
  • Neurology
  • 18 Dec 2019

  • International Clinical Digest
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Takeaway

  • The use of erenumab is not associated with an increased risk for vascular adverse events (AEs) or BP changes compared with placebo in patients with migraine.
  • No association seen even in patients treated with acute migraine-specific medication or with other vascular risk factors.

Why this matters

  • Erenumab blocks a calcitonin gene-related peptide receptor, which can mediate vasodilation.

Study design

  • Meta-analysis identified 4 double-blind, placebo-controlled studies of erenumab and their open-label extensions in patients with chronic or episodic migraine.
  • Treatment groups: placebo (n=1043), erenumab 70 mg (n=893), or erenumab 140 mg (n=507).
  • Funding: Amgen Inc.; Novartis.

Key results

  • During 12 weeks of double-blind treatment, hypertension-related AE rates were 0.9% (placebo), 0.8% (erenumab 70 mg), and 0.2% (erenumab 140 mg).
  • 18 patients had AEs and fulfilled criteria for adjudication, of whom 4 patients had events of cardiovascular origin.
  • Similar AE incidences were noted among users of acute migraine-specific medications:
    • Any AEs: placebo, 49.6%; erenumab 70 mg, 47%; erenumab 140 mg, 46.9%.
    • Serious AEs: placebo, 1.9%; erenumab 70 mg, 2.1%; erenumab 140 mg, 1.5%.
  • Regardless of the number of vascular risk factors, AE incidences were similar across placebo and erenumab groups.

Limitations

  • Open-label study.

Coauthored with Chitra Ravi, MPharm