Background and importance Migraine is the second most prevalent disease in terms of disability-adjusted life years (DALYs). Erenumab, a novel calcitonin gene-related peptide receptor antagonist, has been developed for migraine prevention.
Aim and objectives To evaluate the effectiveness and safety of erenumab in migraine prophylaxis.
Material and methods Retrospective, observational study in patients treated with erenumab from September 2019 to September 2021. Variables collected: demographic (sex, age), type of migraine, presence of aura, dose, Headache Impact Test-6 (HIT-6 ), baseline Migraine Disability Assessment Scale (MIDAS), number of previous treatments, migraine days measured in the last 3 months and duration of treatment. Effectiveness was evaluated by a monthly reduction of ≥50% in migraine days measured at week 12 from start date. To analyse safety, adverse reactions were measured. Information sources: electronic prescription program ATHOS-Prisma and computerised medical record Diraya.
Results Thirty-seven patients were included, 81.1% women, mean age 43.6±13.0 years. The percentage of patients who suffered from chronic migraine was 72.9% and episodic migraine 21.7% (67.5% had aura). The mean HIT-6 was 68.8±4.1 and MIDAS was 60.1±42.1, with a median of 42 (IQR 33–60) days of migraine in the last 3 months prior to erenumab. Thirty-two patients (86.5%) started with a 70 mg dose while the rest started with 140 mg. Eighteen patients (48.7%) increased the dose and the median of previous treatments was 5 (IQR 4–7). Patients who achieved clinical response was 31 (83.8%), of whom 80.6% obtained a reduction of ≥50% in the frequency of migraines. The median of patients’ monitoring was 45 (IQR 24.4–63.3) weeks.
Of six non-responder patients, four of them increased erenumab dose, but only one had positive results. The main adverse effects were: constipation (24.3%), erythema (8%) and nausea and vomiting (2.7%). No patient discontinued treatment due to adverse effects.
Conclusion and relevance Erenumab is an effective and safe alternative in the prophylaxis of migraine refractory to other therapies. More and longer studies are needed to establish the utility of this drug in clinical practice and their long-term safety.
Conflict of interest No conflict of interest
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