Migraine: meta-analysis supports safety and efficacy of prophylactic once-monthly erenumab

  • Lattanzi S & al.
  • Drugs
  • 22 Feb 2019

  • curated by Pavankumar Kamat
  • UK Clinical Digest
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Takeaway

  • Meta-analysis suggests that once-monthly subcutaneous erenumab is effective and well tolerated as prophylactic treatment in patients with episodic and chronic migraine.

Why this matters

  • Monthly dose may increase patient convenience, improve treatment adherence and persistence of preventive treatment.

Study design

  • Meta-analysis of 5 randomised controlled trials (2 phase 2 and 3 phase 3 trials) including 1181 patients with migraine who were randomly assigned to once-monthly subcutaneous erenumab or placebo.
  • Efficacy outcomes: reduction in monthly migraine and monthly acute migraine-specific medication days at 12 weeks.
  • Funding: None.

Key results

  • At week 12, erenumab was associated with a significantly greater reduction in:
    • monthly migraine days (70 mg: mean difference [MD], −1.3; P<.001 mg: md p and>
    • monthly acute migraine-specific medication days (70 mg: MD −1.0, P<.001 mg: md p>
  • No difference was observed between erenumab and placebo group in:
    • adverse event (AE) rate (51.7% vs 53.0%; risk ratio [RR], 0.95; P=.166),
    • serious AE rate (1.8% vs 1.7%; RR, 0.96; P=.893),
    • treatment-related discontinuation rate (1.6% vs 1.2%; RR, 1.12; P=.744).

Limitations

  • Short duration of included trials.

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