Erenumab Is Effective Across Migraine Subtypes, Improves QOL and Disability

Erenumab significantly improves quality of life and reduces migraine-related disability, attack frequency, and acute medication use in adults with episodic and chronic migraine, according to study results from a 2-year real-world study published in Headache.

Migraine remains one of the most prevalent and disabling neurologic disorders worldwide, yet existing prophylactic treatments often yield limited clinical benefit and poor adherence due to tolerability and efficacy concerns. Erenumab, a monoclonal antibody targeting the calcitonin gene-related peptide receptor, was developed specifically for migraine prevention and has shown consistent efficacy in clinical trials. However, long-term data in real-world clinical practice have been limited.

To bridge this knowledge gap, researchers conducted a prospective, noninterventional cohort study. They enrolled 173 adult patients with episodic or chronic migraine from 19 hospital- and office-based neurology sites between 2019 and 2022. Patients received erenumab per the Swiss label, and outcomes were assessed through validated patient-reported tools (Headache Impact Test-6 [HIT-6], modified Migraine Disability Assessment [mMIDAS], Impact of Migraine on Partners and Adolescent Children [IMPAC]), migraine diaries, and health care utilization metrics over 24 months.

Among the predominantly female cohort (84.9%; mean age, 44.2 years), 54.3% had episodic migraine and 45.7% had chronic migraine. After 2 years of treatment, HIT-6 (SD) scores decreased by 8.1 (8.6) points (P <.001), and mMIDAS (SD) scores decreased by 16.6 (21.2) points (P <.001), with greater improvements in patients with chronic migraine (-21.9) compared with those with episodic migraine (-11.5). Monthly migraine days (MMD) decreased by 8.8 days overall, and acute migraine-specific medication use declined by 5.2 days, both statistically significant (P <.001).

Family burden improved substantially, with IMPAC (SD) scores decreasing by 6.5 (6.6) points (P <.001), and more patients shifting from severe to mild impact categories. Response rates showed 76.4% of patients had a 30% or greater reduction in MMD, 59.1% achieved a 50% or greater reduction, and nearly 33% had a 75% or greater reduction. Adverse events (AEs) occurred in 48.6% of patients; the most commonly reported AE was constipation (14.5%), while 9.8% experienced serious events, none of which were linked to the drug. Notably, patients resumed clinical benefit after a mandated treatment interruption, further supporting the sustained effectiveness of erenumab in routine care.

Limitations of the study include its single-arm, observational design, the lack of a comparator group, possible selection bias, and missing data typical of real-world settings.

According to the researchers, “The results show that the therapeutic effects of erenumab observed in clinical trials are also evident in everyday clinical practice.”

Disclosure: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.

This article originally appeared on Clinical Pain Advisor