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. 2020 Aug 15;21(1):102.
doi: 10.1186/s10194-020-01171-w.

Conversion from chronic to episodic migraine in patients treated with erenumab: real-life data from an Italian region

Raffaele Ornello  1 , Alfonsina Casalena  2 , Ilaria Frattale  1 , Valeria Caponnetto  1 , Amleto Gabriele  3 , Giannapia Affaitati  4 , Maria Adele Giamberardino  4 , Maurizio Assetta  2 , Maurizio Maddestra  5 , Fabio Marzoli  5 , Stefano Viola  6 , Davide Cerone  7 , Carmine Marini  8 , Francesca Pistoia  1   7 , Simona Sacco  9
Affiliations

Conversion from chronic to episodic migraine in patients treated with erenumab: real-life data from an Italian region

Raffaele Ornello et al. J Headache Pain. .

Abstract

Background: Most patients treated with erenumab in clinical practice have chronic migraine (CM). We assessed the rate and possible predictors of conversion from CM to episodic migraine (EM) in a real-life study.

Main body: We performed a subgroup analysis of patients treated with erenumab from January 2019 to February 2020 in the Abruzzo region, central Italy. Treatment was provided according to current clinical practice. For the purpose of the present study, we included patients fulfilling the definition of CM for the three months preceding erenumab treatment and with at least 6 months of follow-up after treatment. We assessed the rate of conversion to EM from baseline to Months 4-6 of treatment and during each month of treatment. To test the clinical validity of conversion to EM, we also assessed the decrease in monthly headache days (MHDs), acute medication days, and median headache intensity on a Numerical Rating Scale (NRS). We included in our study 91 patients with CM. At Months 4-6, 62 patients (68.1%) converted from CM to EM; the proportion of converters increased from Month 1 to Month 5. In the overall group of patients, median MHDs decreased from 26.5 (IQR 20-30) to 7.5 (IQR 5-16; P < 0.001) compared with baseline, while median acute medication days decreased from 21 (IQR 16-30) to 6 (IQR 3-10; P < 0.001) and median NRS scores decreased from 8 (IQR 7-9) to 6 (IQR 4-7; P < 0.001). Significant decreases were found both in converters and in non-converters. We found no significant predictors of conversion to EM among the patients' baseline characteristics.

Conclusions: In our study, two thirds of patients with CM converted to EM during 6 months of treatment with erenumab. MHDs, acute medication use, and headache intensity decreased regardless of conversion from CM to EM.

Keywords: Calcitonin gene-related peptide; Chronic migraine; Erenumab; Migraine prevention; Monoclonal antibodies; Real-life study.

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Conflict of interest statement

RO has received sponsorship to attend meetings from Novartis and Teva; SS had a financial relationship (lecturer or member of advisory board) with Abbott, Allergan, Novartis, Teva, and Eli Lilly; GA has received funds for congress participation from Innovet Italia Srl, Epitech Group and Lusofarmaco; MAG received funds for congress participation from IBSA; AC, IF, AG, MA, MM, FM, SV, DC, CM, and FP declare no competing interests.

Figures

Fig. 1
Fig. 1
Rates of conversion to episodic migraine at Months 4–6 and after each month of treatment according to monthly headache days. HFEM indicates high-frequency episodic migraine (8–14 monthly headache days); LFEM, low-frequency episodic migraine (0–3 monthly headache days); MFEM, medium-frequency episodic migraine (4–7 monthly headache days)
Fig. 2
Fig. 2
Decrease in median headache days a, acute medication days b, and headache intensity on a Numerical Rating Scale c according to converter status in the present study
See this image and copyright information in PMC

References

    1. Headache Classification Committee of the International Headache Society (IHS) The International Classification of Headache Disorders, 3rd edition. Cephalalgia. 2018;38 1:1–211; doi: 10.1177/0333102417738202 - PubMed
    1. Del Valle López Martínez M, Pareja Román J, Jiménez Hernández MDU, Ceferino del Carmen Ramírez-Castillejo, María. Chronic Migraine with Medication Overuse: Clinical Pattern and Evolution from a Retrospective Cohort in Seville, Spain. SN Comprehensive Clinical Medicine. 2020; doi: 10.1007/s42399-020-00424-8
    1. Goodhew SC. Migraine literacy and treatment in a university sample. SN Comp Clin Med. 2019;1:749–757. doi: 10.1007/s42399-019-00124-y. - DOI
    1. Ali MW, Musami UB, Sa'ad FK, Omoaghe C, Danimoh MA, Ayoola YA et al (2020) Profile of migraine patients in a developing country: a multicentre study. SN Comp Clin Med. 10.1007/s42399-020-00394-x
    1. Sacco S, Bendtsen L, Ashina M, Reuter U, Terwindt G, Mitsikostas DD, et al. European headache federation guideline on the use of monoclonal antibodies acting on the calcitonin gene related peptide or its receptor for migraine prevention. J Headache Pain. 2019;20(1):6. doi: 10.1186/s10194-018-0955-y. - DOI - PMC - PubMed

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