New drug shows promise for preventing migraines

Faith Castro
December 1, 2017

New research found the injectable drug erenumab cut the number of days people had migraines from an average of 8 a month to between 4 and 5 a month.

Described as a lab-made antibody, Erenumab blocks amino acid calcitonin gene-related peptide (CGRP), which is believed to be a factor in migraine attacks. Around 41% of patients halved migraine occurrences after antibody treatment.

There is an urgent need for new treatment options and erenumab is the first and only fully human monoclonal antibody of its kind created to specifically prevent migraine. Migraines often are accompanied by other symptoms, such as sensitivity to light or sound, and nausea.

The 140mg group had a 3.7-day reduction in monthly migraine days vs. a 3.2-day reduction for the 70mg dose group and a 1.8-day reduction for the placebo group.

Researchers recruited 955 adults aged 18 to 65 who regularly had at least 4 days of migraine a month on average.

At the time, Marcelo Bigal, MD, PhD, chief medical officer & head of specialty clinical development at Teva Pharmaceuticals, the product's developer, told MD Magazine: "If you have chronic migraine, you want to bring them down to episodic, and once they are episodic, the goal is to get you to a lower frequency and prevent them from becoming chronic again".

"I very definitely benefited", said Anne Vickers, who got the lower dose through one of the study leaders at Mercy Hospital St. Louis in Missouri. Those on high dose had a migraine days reduction of 3.7 days while those on placebo had a 1.8 days reduction in the migraine days per month.

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The number of possible side effects reported was similar between those taking placebo and those taking erenumab, suggesting they may not be specific to the drug.

It's not exactly clear how the drugs help disrupt migraines, but CGRP is known to be involved with the way nerves control pain and with blood vessel activity.

The trial "represents an incredibly important step forward for migraine understanding and migraine treatment", said Professor Peter Goadsby, from King's College Hospital, who led the project. Injection site reactions were reported by 47% each of the fremanezumab groups and 40% of the placebo group, most often injection-site pain.

"The effects can last for hours, even days in many cases". Those given the placebo had 2.5 fewer days with headache.

"These drugs are likely to be priced at a high point, and while insurance companies will likely cover them, they may require patients to have tried and failed at other therapies first", Safdieh said. "But there's always a bit of concern when you use a treatment in a developing brain". Once approved, the medication will then be assessed by the National Institute of Health and Care Excellence in the United Kingdom.

There have been clinical trials published on two of these antibodies in the New England Journal of Medicine.

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