Neurology Xagena

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Erenumab for preventive treatment of migraine: efficacy and safety

Novel therapeutic options with improved efficacy and safety profiles are needed for the prophylaxis of migraine.
In recent years, the inhibition of calcitonin gene-related peptide ( CGRP ) signaling has attracted growing interest in the pharmacological research on migraine.
Erenumab ( Aimovig ) is the first fully human monoclonal antibody directed against the CGRP receptor to be approved for use in migraineurs.

The aim of research was to evaluate the efficacy and safety of Erenumab as preventive treatment in patients with migraine using meta-analytical techniques.

Randomized, placebo-controlled, single- or double-blinded trials were identified through a systematic literature search.
Main outcomes included the changes from baseline in monthly migraine days ( MMD ) and monthly acute migraine-specific medication days ( MSMD ) at week 12, and the incidence of adverse events, severe adverse events ( SAEs ) and treatment withdrawal due to adverse events.
Mean difference ( MD ) and risk ratio ( RR ) with 95% confidence intervals ( 95% CIs ) were estimated.

Across the five included trials, Erenumab given as a subcutaneous injection at a monthly dosage of 70 mg and 140 mg was associated with a significantly greater reduction in baseline MMD ( 70 mg: MD - 1.3, 95% CI - 1.7 to - 1.0, p less than 0.001; 140 mg: MD - 1.9, 95% CI - 2.3 to - 1.4, p less than 0.001 ) and MSMD ( 70 mg: MD - 1.0, 95% CI - 1.6 to - 0.4, p less than 0.001; 140 mg: MD - 1.8, 95% CI - 2.5 to - 1.1, p less than 0.001 ) than placebo.

There were no differences in the occurrence of adverse effects, severe adverse effects, and drug withdrawal due to adverse events between the Erenumab and placebo groups.

In conclusion, Erenumab is an efficacious and well tolerated preventive treatment in adult patients with episodic and chronic migraine. ( Xagena )

Lattanzi S et al, Drugs 2019;79 : 417-431