Real-life assessment of erenumab in refractory chronic migraine with medication overuse headache

• DOI: 10.1007/s10072-021-05426-5
• Publication Date: 2021-07-05T13:02:44Z
• Authors: Umberto Pensato; Carlo Baraldi; Valentina Favoni; Maria Michela Cai...; Paola Torelli; Pietro Querzani; Alessia Pascazio; Davide Mascarella; Eleonora Matteo; Simone Quintana; Gian Maria Asioli; Pietro Cortelli; Giulia Pierangeli; Simona Guerzoni; Sabina Cevoli
• Keywords: Anti-CGRP; Calcitonin gene-related peptide; Migraine treatment; OnabotulinumtoxinA; Prophylaxis; Antibodies, Monoclonal, Humanized; Calcitonin Gene-Related Peptide Receptor Antagonists; Headache; Humans; Prospective Studies; Headache Disorders, Secondary; Migraine Disorders; Prophylaxis; Migraine Disorders; Headache; 610; Anti-CGRP; Migraine treatment; Antibodies, Monoclonal, Humanized; 3. Good health; 03 medical and health sciences; 0302 clinical medicine; Calcitonin Gene-Related Peptide Receptor Antagonists; OnabotulinumtoxinA; Calcitonin gene-related peptide; Headache Disorders, Secondary; Humans; Prospective Studies

To determine whether erenumab is effective and safe in refractory chronic migraine with medication overuse headache.In this prospective, multicentric, real-life study, chronic migraine with medication overuse headache patients who received erenumab were recruited. Study inclusion was limited to patients who previously failed onabotulinumtoxinA in addition to at least three other pharmacological commonly used migraine preventive medication classes.Of 396 patients who received erenumab, 38% (n = 149) met inclusion criteria. After 3 months, 51% (n = 76) and 20% (n = 30) patients achieved ≥ 50% and ≥ 75% reduction in monthly headache days, respectively. Monthly pain medications intake decreased from 46.1 ± 35.3 to 16.8 ± 13.9 (p < 0.001), while monthly headache days decreased from 25.4 ± 5.4 to 14.1 ± 8.6 (p < 0.001). Increasing efficacy of erenumab over the study period was observed. Allodynia was a negative predictive factor of erenumab response (odds ratio = 0.47; p = 0.03). Clinical conversion to episodic migraine with no medication overuse was observed in 64% (n = 96) patients. No serious adverse events were observed.Erenumab reduced significantly migraine frequency and pain medication intake in refractory chronic migraine with MOH patients.