Erenumab for episodic migraine prophylaxis

ABSTRACT

Introduction: This paper reviews placebo-controlled randomized double-blind studies with erenumab for the prevention of migraine. Erenumab is a fully human monoclonal antibody (mAb), which specifically blocks the calcitonin gene-related peptide (GGRP) receptor.

Areas covered: This manuscript was based on articles written in English located on PubMed using the following search terms: episodic and chronic migraine, migraine prophylaxis and prevention, CGRP, CGRP receptor, CGRP receptor antagonist, erenumab, treatment failures, and trigeminal nerve.

Expert commentary: The primary endpoints in Phase II and III preventive episodic migraine trials have been reached successfully, and so have multiple secondary endpoints. Monthly subcutaneous injections of either erenumab 70 mg or 140 mg reduced mean monthly migraine days (MMDs) after 3 and 6 months significantly greater than placebo when compared to baseline values with an onset of action within the first week. About 50% of subjects have at least a 50% reduction of MMDs. Several patient-reported outcome measures demonstrate improved quality of life with erenumab. This antibody also shows efficacy in a prior preventive treatment failure population. The tolerability of erenumab is good, which is reflected by low dropout rates in all erenumab clinical trials. Within the first year of treatment, no specific group or type of adverse events were observed.

KEYWORDS:

• Migraine
• prevention
• CGRP
• CGRP receptor
• antibody
• treatment failure
• erenumab

Declaration of interest

U. Reuter has received honorarium for consulting from Amgen, Allergan, Autonomic Technologies, Co-Lucid Eli Lilly, Novartis and TEVA; U. Reuter has received honorarium for scientific presentations by Amgen, Allergan. Eli Lilly, Co Lucid, Medscape, StremedUpMed, Novartis and TEVA. L. Neeb has received honorarium for consulting from Eli Lilly and Novartis; L. Neeb has received honorarium for scientific presentations by Allergan, Desitin, Hormosan, Eli Lilly, Novartis and TEVA. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This paper was not funded.