Erenumab in 159 high frequency and chronic migraine patients: real-life results from the Bologna Headache Center
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Erenumab in 159 high frequency and chronic migraine patients: real-life results from the Bologna Headache Center Eleonora Matteo 1 & Valentina Favoni 2 & Alessia Pascazio 1 & Umberto Pensato 1 & Matteo Benini 1 & Gian Maria Asioli 1 & Elena Merli 1 & Calogero Calabrò 1 & Pietro Cortelli 1,2 & Giulia Pierangeli 1,2 & Sabina Cevoli 2
# Fondazione Società Italiana di Neurologia 2020
Migraine is one of the most prevalent and disabling conditions worldwide. Treatment of migraine can involve both acute and preventive interventions. Patients with frequent headache may require both approaches. Acute treatment is aimed at aborting the headache attack, whereas preventive treatment is geared toward reducing the frequency and severity of attacks. Monoclonal antibodies against CGRP (mAbs) are a novel therapeutic preventive option for patients with migraine [1]. Among mAbs, erenumab selectively targets the CGRP receptor. Randomized controlled trials have proven efficacy and safety of erenumab as preventive treatment for both episodic and chronic migraine (CM); however, real-life studies are still needed to confirm these results in everyday clinical practice. We report preliminary result of a prospective study that evaluates effectiveness and safety of erenumab in a cohort of high-frequency episodic migraine (HFEM) and CM patients in real life. Patients were selected at our Tertiary Headache Centre in Bologna, Italy, between May 2019 and April 2020. Inclusion criteria for eligibility in the study were the following: (i) patients with HFEM (8–14 headache days/month) or CM (≥ 15 headache days/month) with or without MOH, defined according to ICHD-3; (ii) history of more than two migraine prophylactic treatment failures. We excluded patients who were pregnant or breastfeeding as well as patients with major cardiovascular or cerebrovascular events. All eligible patients received treatment with erenumab once every 4 weeks. Erenumab dose was 70 mg for the first 2 months; subsequently, according to the reduction in monthly migraine
* Sabina Cevoli [email protected] 1
Department of Biomedical and NeuroMotor Sciences (DiBiNeM), Bellaria Hospital, Alma Mater Studiorum - University of Bologna, Via Altura 3, 40139 Bologna, Italy
2
IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
days (MMDs), we decided whether to continue with the erenumab 70 mg or to switch to erenumab 140 mg. Our primary endpoints were to assess the percentage of patients that reported a reduction of at least 50% in MMD (50% responder rate) at 3 and at 6 months, and to evaluate treatment safety. Our secondary endpoints included evaluating changes in MMD, monthly pain medication intake (MPMI), and disability scores measured with Headache Impact Test-6 (HIT-6), as well as assessing adherence to treatment during the study period. The study was conducted in agreement with principles of good clinical practice, and the study protocol was approved by the Local Ethics Committee of the local health service of Bologna, Italy (n. CE 20073
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