Early Onset of Efficacy After Erenumab Treatment in Chronic and Episodic Migraines
By week 1, 43% of participants with episodic migraine and 26% of participants with chronic migraine who received erenumab 140 mg had at least a 50% reduction in weekly migraine days.
The onset of erenumab efficacy is observable within the first week post-treatment, according to a post-hoc study in The Journal of Headache and Pain. Researchers reviewed 2 previously published phase 3 studies (1 researching chronic migraine [CM] and 1 researching episodic migraine [EM]).
The investigators performed post-hoc analyses on 2 randomized, placebo-controlled, parallel-group, double-blind studies researching the efficacy of erenumab (70 and 140 mg) on either episodic migraine (ClinicalTrials.gov Identifier: NCT02456740) or chronic migraine (ClinicalTrials.gov Identifier: NCT02066415). Both published studies showed that both doses of erenumab had efficacy in the reduction of monthly migraine days and set up to assess whether efficacy was observed prior to this time point. They evaluated the number of migraine days per week and achievement of greater than 50% reduction from baseline in the total study population.
The baseline migraine days per week in both studies were 2.1±0.6 for episodic migraine and 4.5±1.2 for chronic migraine. In both studies, there were nominally significant reductions in migraine days per week in comparison with placebo. The investigators showed the “odds of achieving a ≥50% reduction from baseline in [migraine days per week] were higher in” participants treated with erenumab in comparison with placebo as early as week 1 and maintained through week 4. The investigators showed that the 7-day moving average was separated based on erenumab vs placebo treatment within the first week. The investigators noted the following post-hoc study design was a study limitation.
These findings suggest that erenumab efficacy onset is observable within the first week after the initial dosage in the previously published studies investigating chronic migraine and episodic migraine.
Disclosures: This study was supported by Amgen and Novartis Pharma AG. Please refer to original reference for a full list of authors' disclosures.
Schwedt T, Reuter U, Tepper S, et al. Early onset of efficacy with erenumab in patients with episodic and chronic migraine [published online October 1, 2018]. J Headache Pain. doi: 10.1186/s10194-018-0923-6