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Introduction Erenumab is a monoclonal antibody which inhibits the calcitonin gene-related peptide (CGRP) receptor. The safety and efficacy of erenumab as a specific prophylactic medication in patients with chronic migraine have been demonstrated in clinical trials. However, real-world data for chronic migraine are still insufficient. Objectives Our aim was to evaluate the effectiveness of erenumab in a real-world setting in patients with chronic migraine after a 6-month treatment period. Methods This study included patients with chronic migraine who failed to respond to three or more classes of prophylactic migraine medication. All patients were recruited in the University Hospital Centre Zagreb, Croatia between March 2019 and November 2019 and received monthly erenumab 70 mg for 6 months. Patient interviews were conducted at the beginning of treatment and after 6 months in order to assess clinical improvement. The clinical parameters chosen for analysis were monthly migraine days (MMD), monthly non-migraine headache days (MND), monthly headache days (MHD), pain intensity measured by the visual-analogue scale (VAS) and monthly acute migraine medication intake. Statistical analysis of the data was performed using the Wilcoxon test. Results Out of the 57 participants who entered the study, 54 received at least one dose of erenumab 70 mg and were included in the analysis. Fifty-one patients (94.44%) were female. The mean age of the patients was 46.5±10.4 years (range 21–72). After 6 months, 70.37% of patients had a >50% reduction in monthly migraine days, while 40.74% had a >75% reduction in MMD. The mean (±SE) value of MMD was reduced from 10.37±0.38 (median 10) to 4.59±0.43 days (median 3) (p < 0.001), while the mean value of MND was reduced from 11.78±0.72 (median 10) to 5.15±0.60 days (median 4) (p < 0.001). The mean (±SE) number of MHD was also reduced from 22.24±0.70 (median 22) to 9.74±0.91 days (median 8) (p < 0.001). Furthermore, mean (±SE) migraine pain intensity measured by the VAS score decreased from 10.00±0 (median 10) to 6.69±0.24 (median 6.5) (p < 0.001). Mean (±SE) monthly acute migraine medication intake decreased from 22.78±0.74 (median 20) to 9.72±1.02 (median 6.5) (p < 0.001) tablets per month. Conclusion The data from this real-world study show that erenumab is an effective prophylactic therapeutic option in patients with chronic migraine. |
