RESEARCH SUBMISSIONS

Timing and durability of response to erenumab in patients with episodic migraine

Peter J. McAllister MD

Corresponding Author

Peter J. McAllister MD

New England Institute for Neurology and Headache, Stamford, Connecticut, USA

Correspondence

Peter J. McAllister, New England Institute for Neurology and Headache, 30 Buxton Farm Road, Suite 230, Stamford, CT 06905, USA.

Email: [email protected]

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Ira Turner MD

Ira Turner MD

Island Neurological Associates, Plainview, New York, USA

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Uwe Reuter MD, PhD

Uwe Reuter MD, PhD

Department of Neurology, Charité Universitätsmedizin Berlin, Berlin, Germany

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Andrea Wang MA

Andrea Wang MA

Amgen Inc., Thousand Oaks, California, USA

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James Scanlon PhD

James Scanlon PhD

Amgen Inc., Thousand Oaks, California, USA

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Jan Klatt MD

Jan Klatt MD

Novartis, Basel, Switzerland

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Denise E. Chou MD

Denise E. Chou MD

Amgen Inc., Thousand Oaks, California, USA

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Gabriel Paiva da Silva Lima MD

Gabriel Paiva da Silva Lima MD

Amgen Inc., Thousand Oaks, California, USA

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First published: 28 November 2021
Citations: 6

Funding information

This study was funded by Amgen Inc.

Abstract

Objective

We sought to evaluate temporal response patterns to erenumab treatment in patients with episodic migraine.

Background

Although many patients treated with erenumab experience onset of efficacy as early as 1 week, clinical benefits of migraine preventive therapies may accrue with continued treatment. Furthermore, details about the maintenance of clinical responses have not been reported.

Methods

This was a post hoc analysis of a 6-month, randomized, double-blind, placebo-controlled, phase 3 study of erenumab for the prevention of episodic migraine. We analyzed temporal responses to erenumab using a threshold of ≥50% reduction from baseline in monthly migraine days (MMDs).

Results

During the 6-month treatment period, 73.7% (230/312) and 79.6% (253/318) of patients in the erenumab 70 mg (n = 312) and 140 mg (n = 318) groups, respectively, achieved a response in at least 1 month. In this group of responders, at least half reached first monthly response (first month with ≥50% reduction from baseline in MMDs) by month 2 and at least 75% of them by month 3. The remainder responded in months 4–6. Of patients in the erenumab 70 and 140 mg groups, 35.3% (110/312) and 41.8% (133/318), respectively, responded over months 1–3 (mean response over first 3 months). Of these patients, 81.8% (90/110) and 81.9% (109/133) maintained this response over months 4–6 (mean response over last 3 months) in the 70 and 140 mg groups, respectively. Many patients who did not achieve an initial response (≥50% reduction from baseline in MMDs during month 1) responded later with continued treatment, with approximately one-half or more of initial nonresponders responding by months 4–6.

Conclusions

These results support guidelines recommending at least 3 months following the initiation of erenumab for migraine prevention before the assessment of response.

CONFLICT OF INTEREST

PJM discloses consulting fees from Alder and research support from Amgen, Biohaven, Eli Lilly, and Teva. IT discloses grants from Allergan, Amgen, Biohaven, ElectroCore, Eli Lilly and Company, Lundbeck (Alder), Nerivio, and Teva. He has received payments for speaking and/or consulting from Allergan, Amgen, Biohaven, Eli Lilly and Company, Lundbeck, Headache Cooperative of New England, Nerivio, Novartis, Revance, Teva, and The Headache Institute. IT received nonfinancial support from Eli Lilly and Company. UR discloses consulting fee, speaking/teaching fee, and/or research grants from Allergan, Amgen, Autonomic Technologies, CoLucid, ElectroCore, Novartis, Pharm Allergan, Eli Lilly, and Teva Pharmaceuticals. AW, JS, DEC, and GPdSL are employees and stockholders of Amgen. JK is an employee and stockholder of Novartis.

DATA AVAILABILITY STATEMENT

Qualified researchers may request data from Amgen clinical studies. Complete details are available at http://www.amgen.com/datasharing.