Erenumab Effective in Patients With Episodic Migraine With Prior Preventive Treatment Failures

The following article is part of conference coverage from the 2019 American Academy of Neurology Annual Meeting (AAN 2019) in Philadelphia, PA. Neurology Advisor’s staff will be reporting breaking news associated with research conducted by leading experts in neurology. Check back for the latest news from AAN 2019.

PHILADELPHIA — Erenumab efficacy was sustained over 24 weeks for patients with difficult-to-treat episodic migraines who had previously experienced multiple preventive treatment failures, according to research presented at the 2019 American Academy of Neurology Annual Meeting, held May 4-10, 2019, in Philadelphia, Pennsylvania.

In an open-label extension phase of the LIBERTY study (ClinicalTrials.gov identifier: NCT03096834), researchers analyzed the efficacy of 140 mg erenumab in patients with episodic migraines with multiple prior preventive treatment failures. Patients (N = 246) were randomly assigned to 140 mg erenumab or placebo for 12 weeks, after which the remaining patients (n = 240) were enrolled in a 3-month open-label extension phase study to receive monthly 140 mg erenumab.

Outcomes were measured throughout the study for the overall population, patients on continuous erenumab, and patients switching to erenumab from placebo. Outcomes included were achievement of at least a 50%/75%/100% reduction in monthly migraine days, a change from monthly acute migraine-specific medication days, double-blind treatment phase baseline in monthly migraine days, everyday activities and physical impairment as measured by the Migraine Physical Function Impact Diary (MPFID), and Headache Impact Test (HIT-6™) total score.

Of the 228 patients (95.0%) who completed the 24-week visit, 39.2% had achieved at least a 50% reduction in monthly migraine days, 15.9% had achieved at least a 75% reduction, and 7.0% had achieved 100% reduction.

The mean change from the double-blind treatment phase baseline was -2.7 (standard deviation [SD] 4.4) in monthly migraine days, -1.4 (SD 3.0) in monthly acute migraine-specific medication days, -7.6 (SD 8.0) in HIT-6™ score, -2.5 (SD 9.2) in MPFID physical impairment score, and -4.0 (SD 9.0) in MPFID everyday activities score. Patients taking erenumab continuously showed sustained efficacy in all outcome measures, and patients switching from placebo to erenumab at week 16 showed improvements in all outcome measures thereafter.

Researchers concluded that the “[e]fficacy of erenumab was sustained throughout 24 weeks in a hard to treat patient population with multiple prior preventive treatment failures. Overall, efficacy data over 24 weeks (assessed over weeks 13-16,17-20, and 21-24) [were] generally in line with prior erenumab trials.”

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Reference

Reuter U, Goadsby P, Lanteri-Minet M, et al. Assessment of the efficacy of erenumab during the open-label treatment (13-24 weeks) of subjects with episodic migraine who failed 2–4 prior preventive treatments: results of the LIBERTY study. Presented at: 2019 American Academy of Neurology Annual Meeting; May 4-10, 2019; Philadelphia, PA.