Abstract

Background

Clinical trials have shown the safety and clinical superiority of erenumab compared to placebo in chronic migraine (CM). The aim of this analysis is to evaluate the effectiveness and tolerability of erenumab in a real-world setting in patients with refractory CM.

Methods

This is a prospective single centre real-world audit conducted in patients with CM with and without medication overuse, refractory to established preventive medications, who received monthly erenumab for 6 months.

Results

Of 164 patients treated, 162 patients (female = 135, mean age 46 ± 14.3 years old) were included in the audit. Patients had failed a mean of 8.4 preventive treatments at baseline and 91% of patients failed Botulinum toxin type A at baseline. The mean reduction in monthly migraine days was 6.0 days at month 3 (P = 0.002) and 7.5 days at month 6 (P < 0.001) compared to baseline. The mean reduction in monthly headache days was 6.3 days (P < 0.001) at month 3 and 6.8 days (P < 0.001) at month 6. At month 3, 49%, 35% and 13% and at month 6, 60%, 38% and 22% of patients obtained at least a 30%, 50% and 75% reduction in migraine days, respectively. The percentage of patients with medication overuse was reduced from 54% at baseline to 20% at month 3 and to 25% at month 6. Compared to baseline, the mean reduction of Headache Impact Test-6 score was 7.7 points at month 3 (from 67.6 ± 0.4 to 59.9 ± 0.9) (P < 0.001) and of 7.5 points at month 6 (60.1 ± 1.3) (P = 0.01). The percentage of patients with severe headache-related disability (HIT-6: 60–78) was reduced from 96% at baseline to 68% after three monthly treatments and to 59% after six treatments. At least one side effect was reported by 48% of patients at month 1, 22% at month 3 and 15% at month 6. Constipation (20%) and cold/flu-like symptoms (15%) were the most frequent adverse events reported.

Conclusion

Erenumab may be an effective and well tolerated therapy for medically refractory CM patients with and without medication overuse.

Details

Title
A prospective real-world analysis of erenumab in refractory chronic migraine
Author
Lambru Giorgio 1 ; Hill, Bethany 1 ; Murphy, Madeleine 1 ; Tylova Ivona 1 ; Andreou, Anna P 2   VIAFID ORCID Logo 

1  Guy’s and St Thomas NHS Foundation Trust, The Headache Centre, Pain Management and Neuromodulation Centre, London, UK (GRID:grid.420545.2) 
2  Guy’s and St Thomas NHS Foundation Trust, The Headache Centre, Pain Management and Neuromodulation Centre, London, UK (GRID:grid.420545.2); King’s College London, Headache Research-Wolfson CARD, Institute of Psychology, Psychiatry and Neuroscience, London, UK (GRID:grid.13097.3c) (ISNI:0000 0001 2322 6764) 
Publication year
2020
Publication date
Dec 2020
Publisher
Springer Nature B.V.
ISSN
11292369
e-ISSN
11292377
Source type
Scholarly Journal
Language of publication
English
DOI
https://doi.org/10.1186/s10194-020-01127-0
ProQuest document ID
2429904921
Copyright
© The Author(s) 2020. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.