Early real-world use of erenumab was associated with high adherence and reductions in previously used acute and preventive medications, according to a study conducted by investigators at Amgen and Veradigm and published in Cephalalgia Reports.1
For this retrospective observational study, de-identified ambulatory patient data were sourced from a large electronic health record (EHR) database used by small group specialty and primary care practices and single providers across the United States. Of the more than 3,000 patients who were prescribed erenumab and who met study inclusion criteria, most (86%) were women and approximately 40% had documentation of chronic migraine.
For patients with six months of follow-up, the mean proportion of days covered by erenumab was 0.86 at three months and 0.79 at six months. Reductions of 9.8% and 10.2% in the number of prescriptions for acute and non-specific preventive medications, respectively, were demonstrated during follow-up compared with a six-month baseline period.
To alleviate migraine attack frequency and severity and reduce disability, clinical management may require the use of both acute and preventive therapies. Traditional oral migraine preventive medications are associated with low adherence rates owing to lack of efficacy and poor tolerability.2,3 Approved for use in the US in 2018 for migraine prevention4 in adults, subcutaneously administered erenumab is the first in a class of migraine-specific preventive therapies that blocks the actions of calcitonin gene-related peptide (CGRP), a proinflammatory neuropeptide implicated in migraine pathophysiology.5
To date, the study is the largest to describe characteristics and treatment patterns of patients who initiated erenumab in US routine clinical practice. The authors state that adherence to monthly dosing and reductions in the use of acute and preventive medications provide support for erenumab’s benefit and that studies with longer follow-up and data on patient-reported outcomes and healthcare resource utilization are needed.
- Bogdanov A, Chia V, Bensink M, et al. Early use of erenumab in US real world practice. Cephalalgia Rep 31 May 2021;4. https://doi.org/10.1177/25158163211020419
- Hepp Z, Dodick DW, Varon SF, et al. Adherence to oral migraine-preventive medications among patients with chronic migraine. Cephalalgia 2015;35(6):478-488. https://pubmed.ncbi.nlm.nih.gov/25164920/
- Hepp Z, Bloudek LM, Varon SF. Systematic review of migraine prophylaxis adherence and persistence. J Manage Care Pharm 2014;20(1):22-33. https://pubmed.ncbi.nlm.nih.gov/24372457/
- Aimovig prescribing information. https://www.accessdata.fda.gov/drugsatfda_docs/label/2018/761077s000lbl.pdf
- Bucklan J, Ahmen Z. CGRP antagonists for decreasing migraine frequency: new options long overdue. Cleve Clin J Med 2020;87(4):211-218. https://pubmed.ncbi.nlm.nih.gov/32238376/