Erenumab Superior to Placebo for Reducing Migraine Disability, Improving HRQoL

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A significantly lower percentage of patients receiving a 70-mg or 140-mg dose of erenumab had severe disability during treatment compared with placebo.
A significantly lower percentage of patients receiving a 70-mg or 140-mg dose of erenumab had severe disability during treatment compared with placebo.

Erenumab, a fully human monoclonal antibody and inhibitor of the canonical calcitonin gene-related peptide receptor, may reduce migraine disability and improve health-related quality of life (HRQoL) in patients with migraine, according to study results published in Cephalalgia.

Data from patients with migraine participating in a 6-month phase 3 randomized controlled trial were included in the analysis (n=955). In the trial, patients were randomly assigned to once-monthly subcutaneous injections of 70 mg erenumab (n=317), 140 mg erenumab (n=319), or placebo (n=319) and were asked to record their migraine and non-migraine headaches using an eDiary.

In addition, participants completed the Headache Impact Test, modified monthly Migraine Disability Assessment Questionnaire (MIDAS), and Migraine-Specific Quality of Life Questionnaire-role function-restrictive (MSQ-RFR), MSQ-role function-preventive (MSQ-RFP), and MSQ-emotional function (MSQ-EF) assessments to help researchers investigate the impact of treatment on everyday life.

Both erenumab doses resulted in significantly greater improvements in patient-reported outcomes from baseline to 6 months. A lower percentage of patients receiving 70 mg erenumab and 140 mg erenumab had severe migraine-related disability over a 4- to 6-month period compared with patients randomly assigned to placebo (38.5% odds ratio (OR) 0.58; P <.001] and 31.1% [OR 0.42; P <.001] vs 51.6%, respectively).

In addition, a significantly lower percentage of patients receiving 70-mg and 140-mg doses of erenumab had severe disability during treatment compared with placebo as determined by the 3-month MIDAS total score (20.2% [OR 0.69; P =.048] and 11.9% [OR 0.37; P <.001] vs 26.9%, respectively). Participants receiving treatment also reported a 5-point increase in MSQ-RFR (72.4% [70 mg] and 67.3% [140 mg] vs 55.1% [placebo]), an 8-point increase in MSQ-EF (52.2% [70 mg] and 49.7% [140 mg] vs 38.9% [placebo]), and a 5-point increase in MSQ-RFP (63.1% [70 mg] and 63.8% [140 mg] vs 51.6% [placebo]) compared with patients in the placebo group.

A limitation of the analysis includes the reliance on self-reported questionnaire data, which were prone to recall bias.

Findings from this trial support the beneficial impact “of erenumab in reducing the burden of migraine and improving the HRQoL of patients, and confirming its role as a promising new therapy for the prevention of episodic migraine,” the researchers stated.

Reference

Buse DC, Lipton RB, Hallström Y, et al. Migraine-related disability, impact, and health-related quality of life among patients with episodic migraine receiving preventive treatment with erenumab [published online August 7, 2018]. Cephalalgia. doi:10.1177/0333102418789072

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