Takeaway
- Erenumab may be an effective and well-tolerated treatment option for patients with refractory chronic migraine (CM) with and without medication overuse.
Why this matters
- Findings along with another recent study provide the first real-world evidence of erenumab efficacy in patients with refractory CM and support its meaningful role even in the complex difficult-to-treat patients with CM.
Study design
- This prospective single-centre real-world audit included 164 patients with refractory CM with and without medication overuse, refractory to established preventive medications, who received monthly erenumab for 6 months.
- Primary outcome: changes in the mean monthly migraine days (MMDs) at 3 and 6 months.
- Secondary outcomes: changes in the mean monthly headache days (MHDs) and monthly headache-free days in patients who reported a 30%-50%-75% reduction in mean MDDs.
- Funding: None disclosed.
Key results
- At month 3 and 6, erenumab demonstrated a significant mean reduction in:
- MMDs: 6.0 days (P=.002) and 7.5 days (P<.001), respectively.
- MHDs: 6.3 days and 6.8 days (P<.001 for both), respectively.
- 49%, 35%, and 13% of patients at 3 months and 60%, 38%, and 22% of patients at 6 months showed at least a 30%, 50%, and 75% reduction in MDDs, respectively.
- The percentage of patients with medication overuse reduced from 54% at baseline to 20% at 3 months and 25% at 6 months.
- Compared with baseline, the mean reduction in Headache Impact Test-6 (HIT-6) score was 7.7 points at 3 months (P<.001) and 7.5 points at 6 months (P=.01).
- The percentage of patients with severe headache-related disability (HIT-6 score) was reduced from 96% at baseline to 68% at 3 months and 59% at 6 months.
- Overall, 48% of patients reported ≥1 side effect at 1 month, 22% at 3 months, and 15% at 6 months.
- Constipation (20%) and cold/flu-like symptoms (15%) were the most common adverse events.
Limitations
- Open-label design.
Lambru G, Hill B, Murphy M, Tylova I, Andreou AP. A prospective real-world analysis of erenumab in refractory chronic migraine. J Headache Pain. 2020;21(1):61. doi: 10.1186/s10194-020-01127-0. PMID: 32487102. View abstract.
This clinical summary first appeared on Univadis, part of the Medscape Professional Network.
