Erenumab was found to be effective and safe to manage patients suffering from chronic migraine complicated with medication overuse headache.

A retrospective, observational trial was performed to investigate the efficacy and safety of erenumab (a monoclonal antibody that blocks the calcitonin gene–related peptide receptor) in individuals with chronic migraine and medication overuse headache in a real-life setting up to one year.

Data concerning 81 participants treated with erenumab were retrospectively assessed in this 12-month real-life trial. The variables monitored every three months were: (i) headache intensity (numeric rating scale score) (ii) Self-Reported Instrument to Assess Work-Related Difficulties in Patients With Migraine (HEADWORK) scores, (iii) average number of painkillers taken per month (analgesic consumption), (iv) 6-item Headache Impact Test (v) mean number of days with painkiller consumption (number of days on medication), and (vi) mean number of headache days per month (headache index).

The analgesic consumption, headache index, and the number of days on medication and the numeric rating scale, 6-item Headache Impact Test, and HEADWORK scores were considerably reduced at every time point from the third month onward in comparison with baseline. No substantial differences were witnessed between individuals who underwent painkiller detoxification prior to initiating erenumab and those who did not.

There were no vital differences between individuals receiving erenumab therapy in combination with other preventive therapies and the individuals taking only erenumab therapy. In this study, five participants dropped out due to adverse events, that were found to resolve after ceasing erenumab. Painkiller withdrawal and the link with other preventive therapies appeared to be of no use.

Erenumab appears to be a promising agent to treat chronic migraine complicated with medication overuse headache.