Efficacy of erenumab to treat headaches in idiopathic intracranial hypertension

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Created On: 19/02/2021

Efficacy of erenumab to treat headaches in idiopathic intracranial hypertension

Therapy for headache in IIH is an urgent unmet need. This prospective, open-label, cohort study was carried to explore the efficacy of erenumab in managing chronic headaches in adult patients with IIH in clinical remission (resolved papilledema).

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Key take away

Erenumab proven effective to manage headache in idiopathic intracranial hypertension (IIH) subjects with resolved papilledema.

Background

Method

The study cohort included 55 women having a confirmed diagnosis of chronic headaches, idiopathic intracranial hypertension in ocular remission and failure of more than three preventative therapeutics. These participants were administered with erenumab (70 mg) four-weekly injections.

The response was evaluated at 3-monthly follow-up consultations over twelve months. Alterations in monthly moderate/severe headache days (MmsHD) from baseline (30-day pretreatment period) to twelve months is the primary endpoint.

Result

At twelve months, both MmsHD and monthly total headache days (MHD) considerably lowered, crystal clear days (days without any head pain) elevated, headache severity (Numeric rating scale [NRS] 0–10) and monthly analgesic days declined. All these measures had improved remarkably by three months, with a consistent vital response to 12 months, as shown in the following table:

A vital improvement was also noted in both quality of life Short Form-36 Health Survey and the Headache impact test-6 score, at 12 months. The sensitivity analysis illustrated comparable outcomes for individuals with or without medication overuse (48% [27/55] subjects) and those with and without a prior migraine diagnosis (52% [28/55] subjects). In 38% (21/55) patients, side effects were witnessed.

Conclusion

The findings favored the use of erenumab for debilitating headaches in idiopathic intracranial hypertension patients. Calcitonin gene-related peptide appears to be a pivotal modulator driving headache and therefore, a vital therapy target.