A study published in the December issue of ‘HEADACHE’ journal concluded that a fully human Ig‐2 monoclonal antibody- Erenumab 70 mg taken orally is safe and effective in the prevention of episodic and chronic migraine (CM).

Piero Barbanti et al. investigated the efficacy of erenumab in migraine patients, while trying to recognize the responsiveness predictors.

Patients in the age group of 18–65 years suffering from high‐frequency episodic migraine (HFEM) or CM, with or without medication overuse were enrolled in this first Italian multicenter, prospective real‐life study. Overall, 372 migraine patients were treated with at least 1 dose of subcutaneous erenumab 70 mg every 4 weeks. Depending on the response by the patient, the treatment period was intended to last from 6-12 months.

In comparison with the baseline, erenumab decreased MMDs by 4.5 ± 4.1 days (mean ± SD) in patients with HFEM and by 9.3 ± 9.1 days in CM patients at weeks 9–12. Both CM and HFEM patients witnessed progressive reductions in Visual Analog Scale (VAS) score, Headache Impact Test scores (HIT), and median monthly analgesics consumption at weeks 9–12. A high ≥50% response rate in a migraine usually considered “hard-to-treat” was one of the main findings of this study (Figure 1 and Figure 2).

The responsiveness of erenumab in HFEM was positively linked with unilateral pain localization, on the other hand in case of CM, it was positively linked with and baseline migraine frequency dopaminergic symptoms, and negatively linked with psychiatric comorbidities.

Patients with HFEM or CM with ≥3 prior preventive therapeutic failures can benefit from erenumab 70 mg by reducing migraine frequency, analgesics usage, provide pain relief, and offers a good safety and tolerability profile.

The study authors noted that easily obtainable clinical features might be of assistance in predicting patient's responsiveness.