As per a post hoc, subgroup analysis of a phase 3, randomized, double-blind, placebo-controlled study (STRIVE), erenumab 70 mg and 140 mg was found to be safe and effective in women who experience menstrual migraine, as published in ‘The Journal of Headache and Pain’. This study was aimed to determine the efficacy and safety of erenumab in females with self-reported menstrual migraine.

During its 6-month double-blind treatment period, the patients received erenumab 70 mg, or erenumab 140 mg and placebo, subcutaneously once in a month. Women with history of menstrual migraine, aged ≤ 50 years old were encompassed in the study. The variation from baseline in monthly migraine days (MMD) and monthly acute migraine-specific medication days (MSMD), percentage of patients achieving ≥ 50% decrease from baseline in MMD, and occurence of adverse events were considered as endpoints.

Out of total 814 women registered in this study, 232 (28.5%) informed a history of menstrual migraine. Out of these women, 214 (92%) had a baseline MMD > 5, signifying a high percentage of women with attacks other than the 5-day peri-menstrual window (2 days prior and 3 days following the beginning of menstruation). The info on “migraine days” comprised of perimenstrual and intermenstrual migraine attacks. Between-group differences from placebo over 4–6 months for erenumab 70 mg and 140 mg were − 1.8 and − 2.1 days for MMD and − 1.6 and − 2.4 days for acute MSMD, correspondingly. Also, during 4–6 months, the likelihood of having a ≥ 50% decrease from baseline in MMD over were 2.2 and 2.8 times larger for erenumab 70 mg and 140 mg, as compared to for placebo. 

Fig: Effectiveness of erenumab in women with a history of menstrual migraine

Generally, Erenumab displayed a safety profile similar to that of placebo.