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. 2022 Feb;43(2):1273-1280.
doi: 10.1007/s10072-021-05426-5. Epub 2021 Jul 5.

Real-life assessment of erenumab in refractory chronic migraine with medication overuse headache

Umberto Pensato #  1 , Carlo Baraldi #  2 , Valentina Favoni  3 , Maria Michela Cainazzo  2 , Paola Torelli  4   5 , Pietro Querzani  6 , Alessia Pascazio  1 , Davide Mascarella  1 , Eleonora Matteo  1 , Simone Quintana  4   5 , Gian Maria Asioli  1 , Pietro Cortelli  1   3 , Giulia Pierangeli  1   3 , Simona Guerzoni  2 , Sabina Cevoli  7
Affiliations

Real-life assessment of erenumab in refractory chronic migraine with medication overuse headache

Umberto Pensato et al. Neurol Sci. 2022 Feb.

Abstract

Objective: To determine whether erenumab is effective and safe in refractory chronic migraine with medication overuse headache.

Methods: In this prospective, multicentric, real-life study, chronic migraine with medication overuse headache patients who received erenumab were recruited. Study inclusion was limited to patients who previously failed onabotulinumtoxinA in addition to at least three other pharmacological commonly used migraine preventive medication classes.

Results: Of 396 patients who received erenumab, 38% (n = 149) met inclusion criteria. After 3 months, 51% (n = 76) and 20% (n = 30) patients achieved ≥ 50% and ≥ 75% reduction in monthly headache days, respectively. Monthly pain medications intake decreased from 46.1 ± 35.3 to 16.8 ± 13.9 (p < 0.001), while monthly headache days decreased from 25.4 ± 5.4 to 14.1 ± 8.6 (p < 0.001). Increasing efficacy of erenumab over the study period was observed. Allodynia was a negative predictive factor of erenumab response (odds ratio = 0.47; p = 0.03). Clinical conversion to episodic migraine with no medication overuse was observed in 64% (n = 96) patients. No serious adverse events were observed.

Conclusions: Erenumab reduced significantly migraine frequency and pain medication intake in refractory chronic migraine with MOH patients.

Keywords: Anti-CGRP; Calcitonin gene-related peptide; Migraine treatment; OnabotulinumtoxinA; Prophylaxis.

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