The human anti-CGRP monoclonal antibody erenumab is approved for the prevention of migraine. Studies suggest that these drugs might not be effective for migraines that have aura.
In a post-hoc review conducted by researchers, they found that erenumab had a significant effect on the frequency of migraine days per month (MMDs) and the use of acute migraine-specific medication (AMSM) in the case of episodic or chronic migraine, irrespective of the severity of the aura.
“These findings suggest that erenumab may be safe and efficient for this patient group,” the authors wrote.
The study was published online today in JAMA Neurology..
Researchers looked at the results from four randomized controlled trials of 2682 patients suffering from migraine with and without aura who received placebo (n = 1043) or erenumab (n = 1400) at a dose of 70 mg or 140 mg. A aura-related history was observed in 46.7 percent of patients who received the erenumab.
In patients suffering from frequent migraines and a history of aura, MMD decreased by -1.1 days (95 percent CI, -1.7 to -0.6) in those who received 70 mg and -0.9 days (95 percent CI, -1.6 to -0.2) in those who received 140 mg when compared to placebo.
Patients suffering from chronic migraine and a history o aura showed an increase in MMD of -2.1 days (95% CI -3.8 to –0.5) when they received 70 mg of erenumab, and -3.1 days (95% CI -4.8 to -1.4) for those who received 140 mg.
AMSMs had a significantly lower percentage of days in which rescue medications were required in patients who were using them. For patients with chronic migraine and a history of aura, the difference between AMSM days and baseline was -0.9 (95%CI, -11.4 to -3.3) for those who received 70 mg of Erenumab and -1.3 (95%CI, 2.0 to 0.5) for those who received 140 mg.
Chronic migraine sufferers experienced a difference of -2.4 (95% confidence interval, -3.9 to –1.0) for those who received 70 mg of Erenumab and -3.7 (95 percent confidence interval, -5.0-2.3) for those who received 140 mg.
Safety profiles were comparable across all subgroups. There were no differences in MMD or AMSM with erenumab throughout long-term analysis regardless of aura status.
The study was funded by Amgen Inc. Lead author Messoud Ashina, MD, PhD, DMSc, is a consultant or scientific advisor for AbbVie, Allergan, Amgen, Eli Lilly, Lundbeck, Novartis, and Teva Pharmaceuticals. Full disclosures for Ashina and other authors can be found in the original report.
JAMA Neurol. Published online December 20th the year 2021. Full Text
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