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Meta-Analysis
. 2019 Dec;98(52):e18483.
doi: 10.1097/MD.0000000000018483.

Erenumab safety and efficacy in migraine: A systematic review and meta-analysis of randomized clinical trials

Changyu Zhu  1 , Jianmei Guan  2 , Hua Xiao  3   4 , Weinan Luo  3   4 , Rongsheng Tong  3   4
Affiliations
Meta-Analysis

Erenumab safety and efficacy in migraine: A systematic review and meta-analysis of randomized clinical trials

Changyu Zhu et al. Medicine (Baltimore). 2019 Dec.

Abstract

Background: Erenumab is a new medicine recently approved in the United States of America for the preventive treatment of migraine among adults. We aimed to conduct a meta-analysis and evaluation of the efficacy and safety of erenumab among patients with migraine.

Methods: The electronic databases that were searched comprised PubMed, Embase and the Cochrane library, which were independently retrieved by 2 reviewers. Only randomized controlled trials (RCTs) that compared placebo with erenumab were selected. Mean differences (MDs), pooled risk ratios (RRs), and their corresponding 95% confidence intervals (CIs) were calculated for continuous and dichotomous data, respectively.

Results: Five RCTs representing 2928 patients were included. Pooled analysis showed significant reductions in the 50% responder rate (RR 1.55; P < .00001; I = 49%). In addition, the mean monthly migraine days from baseline in the erenumab group compared with placebo (MD-1.32; P < .00001; I = 100%) and migraine-specific medication days) from baseline (MD-1.41; P < .00001; I = 100%) were significantly decreased for the erenumab group as compared with placebo. Furthermore, Migraine-specific medication days from baseline in the 140 mg erenumab group were significantly reduced as compared the 70 mg group (MD = 0.55; P < .00001; I = 90%). Finally, there was no significant difference between the erenumab group and placebo for any adverse event and serious adverse event.

Conclusion: Among patients with migraine, both 70 and 140 mg of erenumab were associated with reduced Migraine-specific medication days, Migraine-specific medication days from baseline, and an increased rate of a 50% reduction, in the absence of an increased risk of any serious adverse effect.

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Conflict of interest statement

This study and the analyses contained herein were supported by the National Key Specialty Construction Project of Clinical Pharmacy (Gran No. 30305030698). The funding was aligned to staff compensation accounting, budgeting the design of the study, and the collection, and interpretation of data and in drafting the manuscript. Authors declare that they have no real or perceived financial or academic conflicts of interest in regard the conduct of this work, or its synthesis and publication.

Figures

Figure 1
Figure 1
Flow diagram of literature search and study selection based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) recommendation.
Figure 2
Figure 2
Forest plot of ≥50% responder rate (Erenumab vs placebo).
Figure 3
Figure 3
Forest plot of ≥50% responder rate (70 mg vs 140 mg Erenumab).
Figure 4
Figure 4
Forest plot of mean monthly migraine days from baseline (Erenumab vs placebo).
Figure 5
Figure 5
Forest plot of mean monthly migraine days from baseline (70 mg vs 140 mg Erenumab).
Figure 6
Figure 6
Forest plot of migraine-specific medication days from baseline (Erenumab vs placebo).
Figure 7
Figure 7
Forest plot of migraine-specific medication days from baseline (Erenumab 70 mg vs 140 mg).
Figure 8
Figure 8
Forest plot of adverse events (Erenumab vs placebo).
Figure 9
Figure 9
Forest plot of adverse events (70 mg vs 140 mg Erenumab).
Figure 10
Figure 10
Forest plot of serious adverse events (Erenumab vs placebo).
Figure 11
Figure 11
Forest plot of serious adverse events (70 mg vs 140 mg Erenumab).
See this image and copyright information in PMC

References

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