Erenumab Effective for Treatment of Migraine With or Without Aura

According to recent findings published in JAMA Neurology, erenumab can be safe and effective for the treatment of migraine for patients with and without history of aura.

“Currently, no well-established treatments are available to abort or prevent aura symptoms, and therapeutic responses to acute therapy, specifically sumatriptan, may be different in migraine with aura compared with migraine without aura. The evidence is mixed on the association of aura with preventive treatments for migraine,” wrote Messoud Ashina, MD, PhD, DMSc, Danish Headache Center, Department of Neurology, Rigshospitalet Glostrup, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark, and co-researchers on the need for the analysis.

Dr Ashina et al aimed to assess the safety and efficacy of erenumab as treatment of migraine with aura.

Researchers evaluated 4 double-blind, placebo-controlled randomized clinical trials through this post hoc secondary analysis. A total of 2682 participants with episodic migraine or chronic migraine aged 18 to 65 were spread across these 4 trials conducted in treatment centers in Europe, Russia, North America, and Turkey between August 6, 2013 and November 12, 2019. All participants were randomized to receive erenumab(n = 1400) or placebo(n = 1043). Participants in the erenumab treatment arm either received a dose of 70 mg or 140 mg.

Efficacy endpoints included changes in monthly migraine days(MMD) and acute migraine-specific medication(AMSM) days, as well as the observed rate of patients experiencing 50% or greater reduction in MMDs,

Patients in the erenumab-receiving groups had a greater reduction from baseline in MMDs and AMSM days when compared to placebo-receiving groups.

Compared to placebo, patients with episodic migraine with a history of aura in the erenumab, 70 mg, group had least-squares mean differences in change from baseline MMDs at week 12 of -1.1, while those in the erenumab, 140 mg, group had least-squares mean differences in change from baseline MMDs at week 12 of -0.9.

Patients with chronic migraine and a history of aura in the erenumab, 70mg, group had a lease-squares mean difference from placebo treatment of -2.1 while those who received erenumab, 140 mg had a least-squares mean difference from placebo treatment of -3.1.

“Overall safety profiles were similar across treatment groups regardless of aura history and were comparable to that of placebo over 12 weeks, with no increased emergence of adverse events over time,” wrote Dr Ashina et al.

These findings suggest that erenumab reduces migraine frequency and AMSM days in patients with migraine with or without history of aura.

“The findings support the efficacy and safety of using erenumab in this patient population,” Dr Ashina et al concluded.

Reference:

Ashina M, Goadsby PJ, Dodick DW, et al. Assessment of erenumab safety and efficacy in patients with migraine with and without aura: a secondary analysis of randomized clinical trials. JAMA Neurol. Published online December 20, 2021. doi:10.1001/jamaneurol.2021.4678