Erenumab for Preventive Treatment of Migraine: A Systematic Review and Meta-Analysis of Efficacy and Safety
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SYSTEMATIC REVIEW
Erenumab for Preventive Treatment of Migraine: A Systematic Review and Meta‑Analysis of Efficacy and Safety Simona Lattanzi1 · Francesco Brigo2,3 · Eugen Trinka4,5,6 · Fabrizio Vernieri7 · Tommaso Corradetti1 · Mauro Dobran8 · Mauro Silvestrini1
© Springer Nature Switzerland AG 2019
Abstract Background Novel therapeutic options with improved efficacy and safety profiles are needed for the prophylaxis of migraine. In recent years, the inhibition of calcitonin gene-related peptide (CGRP) signaling has attracted growing interest in the pharmacological research on migraine. Erenumab is the first fully human monoclonal antibody directed against the CGRP receptor to be approved for use in migraineurs. Objective To evaluate the efficacy and safety of erenumab as preventive treatment in patients with migraine using metaanalytical techniques. Methods Randomized, placebo-controlled, single- or double-blinded trials were identified through a systematic literature search (October week 4, 2018). Main outcomes included the changes from baseline in monthly migraine days (MMD) and monthly acute migraine-specific medication days (MSMD) at week 12, and the incidence of adverse events (AEs), severe AEs (SAEs) and treatment withdrawal due to AEs. Mean difference (MD) and risk ratio (RR) with 95% confidence intervals (95% CIs) were estimated. Results Across the five included trials, erenumab given as a subcutaneous injection at a monthly dosage of 70 mg and 140 mg was associated with a significantly greater reduction in baseline MMD (70 mg: MD − 1.3, 95% CI − 1.7 to − 1.0, p
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