Background and Importance Migraine is a highly disabling disease, especially in patients with high frequency episodic migraine and chronic migraine. Migraine management is limited due to side effects and a lack of effectiveness of current available prophylactic therapies. Erenumab is a monoclonal antibody approved with a specific mechanism of action in the prevention of migraine, blocking the activity of calcitonin-gene-related peptide (CGRP), a potent vasodilator which plays a role in pain signalling activities.
Aim and Objectives To quantify patients who achieve clinical benefit with erenumab (50% reduction in monthly migraine days) and describe of erenumab safety profile in a second-level hospital.
Material and Methods Observational and retrospective study that includes all patients treated with at least three doses of erenumab in our hospital. As a limitation, it is decided to start treatment only in patients with > 8 monthly migraine days and with previous failure to at least three prophylactic drugs. The following data were collected: sex, age, previous monthly migraines days, previous non-effective prophylactic treatments, current migraines days, dose of erenumab and related adverse effects.
Results 34 patients were selected, 82.4% of whom were women and the average age was 44.5 years (s=13.1). 26.5% of patients (9 patients) had 15 or more monthly migraine days before treatment with erenumab. The average number of prophylactic treatments was 4.6 (s=1.7), and the most frequently used were amitriptyline (20.9% of patients), topiramate (19.6%), flunarizine (18.3%) and zonisamide (10.5%). 73.5% of patients (25 patients) achieved clinical benefit, 47.1% of them with the minimum dose of 70 mg. The remaining 9 patients of the sample abandoned treatment, 8 due to non-effectiveness and 1 due to lack of adherence. 40% of patients who achieved clinical benefit (10 patients) are just now in a phase of interruption due to a maintenance of effectiveness. Side effects: 5 patients suffered constipation, 1 paraesthesia and 1 itch at the injection site.
Conclusion and Relevance Although the patient sample offered is small, erenumab appears to be an effective and safe option for selected patients with high-frequency migraines who have exhausted traditional alternatives.
Conflict of Interest No conflict of interest
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