To assess the effectiveness and safety of Erenumab, a monoclonal antibody to calcitonin gene-related peptide receptors, in patients with high-frequency episodic migraine (HFEM) in real-life study.
35 patients with HFEM without aura (≥8-14 attacks per month) (30 females, mean age 32.4±8.1) received monthly subcutaneous administration of Erenumab 70 mg for 3 months. The primary endpoint was the change in monthly migraine days (MMDs) from baseline, the secondary endpoint was the proportion of patients who achieved a 50% reduction in the number of days with headache. The change in pain intensity, change in the number of days of use of acute migraine-specific medication, the effect on daily activity (HIT-6 scale, MIDAS), anxiety and depression (the Hospital Anxiety and Depression Scale) were assessed.
At the end of the third month Erenumab decreased MMDs by 5±3.6 (=0.00000). A 50% reduction in the mean number of migraine days per month was achieved for 60% of patients, the intensity of headache according to the visual analogue scale from 8±1.2 points to 5±2 points (=0.00000), monthly analgesics intake passed from 11±7 to 4.5±3.7 (=0.000001). 25.7% of patients did not respond to treatment, showing less than a 30% decrease in the number of days with headache. A decrease in pain intensity correlated with a decrease in anxiety (from 8±4 to 6±4 points (=0.003)) and depression (from 6±4 to 4±3 points (=0.0004)) according to HADS, reduced HIT-6 scale from 65±6 to 55±7 points (=0.00000) and MIDAS from 45 [33; 67] points to 16 [5; 33] (=0.000004)). Patients reported good tolerability of Erenumab. 25.7% of patients noted a tendency to constipation. No patient discontinued treatment due to adverse events.
Real-life study confirmed the efficacy and safety of Erenumab in the treatment of HFEM, a decrease in the severity of comorbid anxiety and depression, and social maladjustment.