The appropriate dosing of erenumab for migraine prevention after multiple preventive treatment failures: a critical appraisal
Abstract Background Erenumab, a fully human monoclonal antibody directed against the calcitonin gene-related peptide receptor, was approved for the prevention of episodic (EM) or chronic migraine (CM) at the monthly dose of 70 mg or 140 mg. We reviewed the available literature to understand if patie...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2019-10-01
|
| Series: | The Journal of Headache and Pain |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s10194-019-1054-4 |
| _version_ | 1819230053874008064 |
|---|---|
| author | Raffaele Ornello Cindy Tiseo Ilaria Frattale Giulia Perrotta Carmine Marini Francesca Pistoia Simona Sacco |
| author_facet | Raffaele Ornello Cindy Tiseo Ilaria Frattale Giulia Perrotta Carmine Marini Francesca Pistoia Simona Sacco |
| author_sort | Raffaele Ornello |
| collection | DOAJ |
| description | Abstract Background Erenumab, a fully human monoclonal antibody directed against the calcitonin gene-related peptide receptor, was approved for the prevention of episodic (EM) or chronic migraine (CM) at the monthly dose of 70 mg or 140 mg. We reviewed the available literature to understand if patients with prior preventive treatment failures benefit more from the 140 mg dose than the 70 mg. Main body We searched papers indexed in PubMed and conference abstracts published in the last 2 years which assessed the safety and efficacy of erenumab in patients with prior preventive treatment failures. We reviewed the results of 3 randomized controlled trials and their subgroup analyses and open-label extensions. The 140 mg monthly dose of erenumab had a numerical advantage over the 70 mg monthly dose in patients with prior preventive treatment failures, both in EM and CM (with or without medication overuse) during the double blind phases of the trials and their open-label extensions. The numerical difference between the two doses increased with the increase in the number of prior preventive treatment failures. Conclusions The available data suggest that erenumab 140 mg monthly might be preferred over the 70 mg monthly dose in patients with EM or CM and prior preventive treatment failures. Further data are needed to assess the long-term efficacy in clinical practice of the two doses of erenumab, while their safety profile is comparable. |
| first_indexed | 2024-12-23T11:22:57Z |
| format | Article |
| id | doaj.art-7d0654adb0174a219c2e6e6d0ca88f4e |
| institution | Directory Open Access Journal |
| issn | 1129-2369 1129-2377 |
| language | English |
| last_indexed | 2024-12-23T11:22:57Z |
| publishDate | 2019-10-01 |
| publisher | BMC |
| record_format | Article |
| series | The Journal of Headache and Pain |
| spelling | doaj.art-7d0654adb0174a219c2e6e6d0ca88f4e2022-12-21T17:49:02ZengBMCThe Journal of Headache and Pain1129-23691129-23772019-10-012011610.1186/s10194-019-1054-4The appropriate dosing of erenumab for migraine prevention after multiple preventive treatment failures: a critical appraisalRaffaele Ornello0Cindy Tiseo1Ilaria Frattale2Giulia Perrotta3Carmine Marini4Francesca Pistoia5Simona Sacco6Neuroscience Section, Department of Applied Clinical Sciences and Biotechnology, University of L’AquilaNeuroscience Section, Department of Applied Clinical Sciences and Biotechnology, University of L’AquilaNeuroscience Section, Department of Applied Clinical Sciences and Biotechnology, University of L’AquilaNeuroscience Section, Department of Applied Clinical Sciences and Biotechnology, University of L’AquilaDepartment of Life, Health and Environmental Sciences, University of L’AquilaNeuroscience Section, Department of Applied Clinical Sciences and Biotechnology, University of L’AquilaNeuroscience Section, Department of Applied Clinical Sciences and Biotechnology, University of L’AquilaAbstract Background Erenumab, a fully human monoclonal antibody directed against the calcitonin gene-related peptide receptor, was approved for the prevention of episodic (EM) or chronic migraine (CM) at the monthly dose of 70 mg or 140 mg. We reviewed the available literature to understand if patients with prior preventive treatment failures benefit more from the 140 mg dose than the 70 mg. Main body We searched papers indexed in PubMed and conference abstracts published in the last 2 years which assessed the safety and efficacy of erenumab in patients with prior preventive treatment failures. We reviewed the results of 3 randomized controlled trials and their subgroup analyses and open-label extensions. The 140 mg monthly dose of erenumab had a numerical advantage over the 70 mg monthly dose in patients with prior preventive treatment failures, both in EM and CM (with or without medication overuse) during the double blind phases of the trials and their open-label extensions. The numerical difference between the two doses increased with the increase in the number of prior preventive treatment failures. Conclusions The available data suggest that erenumab 140 mg monthly might be preferred over the 70 mg monthly dose in patients with EM or CM and prior preventive treatment failures. Further data are needed to assess the long-term efficacy in clinical practice of the two doses of erenumab, while their safety profile is comparable.http://link.springer.com/article/10.1186/s10194-019-1054-4MigraineCalcitonin gene-related peptideMigraine preventionMonoclonal antibodiesErenumab |
| spellingShingle | Raffaele Ornello Cindy Tiseo Ilaria Frattale Giulia Perrotta Carmine Marini Francesca Pistoia Simona Sacco The appropriate dosing of erenumab for migraine prevention after multiple preventive treatment failures: a critical appraisal The Journal of Headache and Pain Migraine Calcitonin gene-related peptide Migraine prevention Monoclonal antibodies Erenumab |
| title | The appropriate dosing of erenumab for migraine prevention after multiple preventive treatment failures: a critical appraisal |
| title_full | The appropriate dosing of erenumab for migraine prevention after multiple preventive treatment failures: a critical appraisal |
| title_fullStr | The appropriate dosing of erenumab for migraine prevention after multiple preventive treatment failures: a critical appraisal |
| title_full_unstemmed | The appropriate dosing of erenumab for migraine prevention after multiple preventive treatment failures: a critical appraisal |
| title_short | The appropriate dosing of erenumab for migraine prevention after multiple preventive treatment failures: a critical appraisal |
| title_sort | appropriate dosing of erenumab for migraine prevention after multiple preventive treatment failures a critical appraisal |
| topic | Migraine Calcitonin gene-related peptide Migraine prevention Monoclonal antibodies Erenumab |
| url | http://link.springer.com/article/10.1186/s10194-019-1054-4 |
| work_keys_str_mv | AT raffaeleornello theappropriatedosingoferenumabformigrainepreventionaftermultiplepreventivetreatmentfailuresacriticalappraisal AT cindytiseo theappropriatedosingoferenumabformigrainepreventionaftermultiplepreventivetreatmentfailuresacriticalappraisal AT ilariafrattale theappropriatedosingoferenumabformigrainepreventionaftermultiplepreventivetreatmentfailuresacriticalappraisal AT giuliaperrotta theappropriatedosingoferenumabformigrainepreventionaftermultiplepreventivetreatmentfailuresacriticalappraisal AT carminemarini theappropriatedosingoferenumabformigrainepreventionaftermultiplepreventivetreatmentfailuresacriticalappraisal AT francescapistoia theappropriatedosingoferenumabformigrainepreventionaftermultiplepreventivetreatmentfailuresacriticalappraisal AT simonasacco theappropriatedosingoferenumabformigrainepreventionaftermultiplepreventivetreatmentfailuresacriticalappraisal AT raffaeleornello appropriatedosingoferenumabformigrainepreventionaftermultiplepreventivetreatmentfailuresacriticalappraisal AT cindytiseo appropriatedosingoferenumabformigrainepreventionaftermultiplepreventivetreatmentfailuresacriticalappraisal AT ilariafrattale appropriatedosingoferenumabformigrainepreventionaftermultiplepreventivetreatmentfailuresacriticalappraisal AT giuliaperrotta appropriatedosingoferenumabformigrainepreventionaftermultiplepreventivetreatmentfailuresacriticalappraisal AT carminemarini appropriatedosingoferenumabformigrainepreventionaftermultiplepreventivetreatmentfailuresacriticalappraisal AT francescapistoia appropriatedosingoferenumabformigrainepreventionaftermultiplepreventivetreatmentfailuresacriticalappraisal AT simonasacco appropriatedosingoferenumabformigrainepreventionaftermultiplepreventivetreatmentfailuresacriticalappraisal |