Login Register Cart 0
Generic placeholder image

Current Neuropharmacology

Editor-in-Chief

ISSN (Print): 1570-159X
ISSN (Online): 1875-6190

Back
Journal Home About Journal Editorial Board Journal Insight Current Issue Volumes/Issues
Subscribe
Systematic Review Article

Optimal Dose of Erenumab for Preventive Treatment of Episodic Migraine: A Systematic Review and Meta-Analysis

Author(s): Yanbo Yang, Mingjia Chen, Da Wu, Yue Sun, Fan Jiang, Zhouqing Chen* and Zhong Wang*

Volume 20, Issue 2, 2022

Published on: 05 January, 2022

Page: [460 - 470] Pages: 11

DOI: 10.2174/1570159X19666210823104916

Price: $65

Abstract

Background: Erenumab is a novel monoclonal calcitonin gene-related peptide receptor antibody that is used for the preventive treatment of migraine.

Objectives: This study aimed to evaluate the overall safety, efficacy, and dose-response relationship of erenumab in patients with episodic migraine and patients with prior migraine treatment failures.

Methods: We searched randomized clinical trials on PUBMED, EMBASE database, and Cochrane Library database. A pair-wise meta-analysis and Bayesian network analysis were performed.

Results: For efficacy outcomes, the network meta-analysis suggests that in comparison to erenumab 70 mg, participants who received erenumab 140 mg reported a significant decrease in monthly acute Migraine-Specific Medication Days (MSMD) and 50% increase in response rate, and erenumab was most likely to be ranked first for Monthly Migraine Days (MMD), MSMD, and 50% response rate. For safety outcomes, the network meta-analysis has found no significant difference between the 70 mg group and the 140 mg group measured by adverse events and serious adverse events. In the 140 mg erenumab group, a significant decreased in MMD and MSMD and 50% and 75% increased in response rate were reported in patients with ≥ 2 treatment failures compared to placebo. For safety outcomes, no significant difference was found between the 140 mg erenumab group and the placebo group.

Conclusion: Erenumab was effective in patients with episodic migraine. A total of 140 mg erenumab was associated with better efficacy outcomes without any increased risk for developing adverse events compared to 70 mg erenumab. Furthermore, 140 mg erenumab was effective in patients with prior migraine treatment failures.

Keywords: Calcitonin gene-related peptide receptor antagonist, erenumab, migraine, network meta-analysis, MSMD, MMD.

« Previous Next »
Graphical Abstract

[1]
Lattanzi, S.; Brigo, F.; Trinka, E.; Vernieri, F.; Corradetti, T.; Dobran, M.; Silvestrini, M. Erenumab for preventive treatment of migraine: a systematic review and meta-analysis of efficacy and safety. Drugs, 2019, 79(4), 417-431.
[http://dx.doi.org/10.1007/s40265-019-01069-1] [PMID: 30793254]
[2]
Goadsby, P.J.; Edvinsson, L.; Ekman, R. Vasoactive peptide release in the extracerebral circulation of humans during migraine headache. Ann. Neurol., 1990, 28(2), 183-187.
[http://dx.doi.org/10.1002/ana.410280213] [PMID: 1699472]
[3]
Amara, S.G.; Jonas, V.; Rosenfeld, M.G.; Ong, E.S.; Evans, R.M. Alternative RNA processing in calcitonin gene expression generates mRNAs encoding different polypeptide products. Nature, 1982, 298(5871), 240-244.
[http://dx.doi.org/10.1038/298240a0] [PMID: 6283379]
[4]
Ho, T.W.; Edvinsson, L.; Goadsby, P.J. CGRP and its receptors provide new insights into migraine pathophysiology. Nat. Rev. Neurol., 2010, 6(10), 573-582.
[http://dx.doi.org/10.1038/nrneurol.2010.127] [PMID: 20820195]
[5]
Tiseo, C.; Ornello, R.; Pistoia, F.; Sacco, S. How to integrate monoclonal antibodies targeting the calcitonin gene-related peptide or its receptor in daily clinical practice. J. Headache Pain, 2019, 20(1), 49.
[http://dx.doi.org/10.1186/s10194-019-1000-5] [PMID: 31060490]
[6]
Traynor, K. FDA approves licensing of erenumab-aooe to prevent migraine. J. Health Syst., 2018, 75(13), 929-930.
[7]
Ornello, R.; Tiseo, C.; Frattale, I.; Perrotta, G.; Marini, C.; Pistoia, F.; Sacco, S. The appropriate dosing of erenumab for migraine prevention after multiple preventive treatment failures: A critical appraisal. J. Headache Pain, 2019, 20(1), 99.
[http://dx.doi.org/10.1186/s10194-019-1054-4] [PMID: 31666008]
[8]
Liberati, A.; Altman, D.G.; Tetzlaff, J.; Mulrow, C.; Gøtzsche, P.C.; Ioannidis, J.P.; Clarke, M.; Devereaux, P.J.; Kleijnen, J.; Moher, D. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration. BMJ, 2009, 339, b2700.
[http://dx.doi.org/10.1136/bmj.b2700] [PMID: 19622552]
[9]
Sakai, F.; Takeshima, T.; Tatsuoka, Y.; Hirata, K.; Lenz, R.; Wang, Y.; Cheng, S.; Hirama, T.; Mikol, D.D. A Randomized phase 2 study of erenumab for the prevention of episodic migraine in japanese adults. Headache, 2019, 59(10), 1731-1742.
[http://dx.doi.org/10.1111/head.13652] [PMID: 31612482]
[10]
Dodick, D.W.; Ashina, M.; Brandes, J.L.; Kudrow, D.; Lanteri-Minet, M.; Osipova, V.; Palmer, K.; Picard, H.; Mikol, D.D.; Lenz, R.A. ARISE: A Phase 3 randomized trial of erenumab for episodic migraine. Cephalalgia, 2018, 38(6), 1026-1037.
[11]
Reuter, U.; Goadsby, P.J.; Lanteri-Minet, M.; Wen, S.; Hours-Zesiger, P.; Ferrari, M.D.; Klatt, J. Efficacy and tolerability of erenumab in patients with episodic migraine in whom two-to-four previous preventive treatments were unsuccessful: A randomised, double-blind, placebo-controlled, phase 3b study. Lancet, 2018, 392(10161), 2280-2287.
[http://dx.doi.org/10.1016/S0140-6736(18)32534-0] [PMID: 30360965]
[12]
Goadsby, P.J.; Reuter, U.; Hallström, Y.; Broessner, G.; Bonner, J.H.; Zhang, F.; Sapra, S.; Picard, H.; Mikol, D.D.; Lenz, R.A. A controlled trial of erenumab for episodic migraine. N. Engl. J. Med., 2017, 377(22), 2123-2132.
[http://dx.doi.org/10.1056/NEJMoa1705848] [PMID: 29171821]
[13]
Sun, H.; Dodick, D.W.; Silberstein, S.; Goadsby, P.J.; Reuter, U.; Ashina, M.; Saper, J.; Cady, R.; Chon, Y.; Dietrich, J.; Lenz, R. Safety and efficacy of AMG 334 for prevention of episodic migraine: A randomised, double-blind, placebo-controlled, phase 2 trial. Lancet Neurol., 2016, 15(4), 382-390.
[http://dx.doi.org/10.1016/S1474-4422(16)00019-3] [PMID: 26879279]
[14]
Goadsby, P.J.; Paemeleire, K.; Broessner, G.; Brandes, J.; Klatt, J.; Zhang, F.; Picard, H.; Lenz, R.; Mikol, D.D. Efficacy and safety of erenumab (AMG334) in episodic migraine patients with prior preventive treatment failure: A subgroup analysis of a randomized, double-blind, placebo-controlled study. Cephalalgia, 2019, 39(7), 817-826.
[15]
Goadsby, P.J.; Holland, P.R.; Martins-Oliveira, M.; Hoffmann, J.; Schankin, C.; Akerman, S. Pathophysiology of migraine: a disorder of sensory processing. Physiol. Rev., 2017, 97(2), 553-622.
[http://dx.doi.org/10.1152/physrev.00034.2015] [PMID: 28179394]
[16]
Goadsby, P.J.; Edvinsson, L.; Ekman, R. Release of vasoactive peptides in the extracerebral circulation of humans and the cat during activation of the trigemino vascular system. Ann. Neurol., 1988, 23(2), 193-196.
[http://dx.doi.org/10.1002/ana.410230214] [PMID: 2454066]
[17]
Lassen, L.H.; Haderslev, P.A.; Jacobsen, V.B.; Iversen, H.K.; Sperling, B.; Olesen, J. CGRP may play a causative role in migraine. Cephalalgia, 2002, 22(1), 54-61.
[18]
Diener, H.C. CGRP as a new target in prevention and treatment of migraine. Lancet Neurol., 2014, 13(11), 1065-1067.
[http://dx.doi.org/10.1016/S1474-4422(14)70228-5] [PMID: 25297015]
[19]
Hepp, Z.; Dodick, D.W.; Varon, S.F.; Gillard, P.; Hansen, R.N.; Devine, E.B. Adherence to oral migraine-preventive medications among patients with chronic migraine. Cephalalgia, 2015, 35(6), 478-488.
[20]
Jain, S.; Yuan, H.; Spare, N.; Silberstein, S.D. Erenumab in the treatment of migraine. Pain Manag. (Lond.), 2018, 8(6), 415-426.
[http://dx.doi.org/10.2217/pmt-2018-0037] [PMID: 30235976]
[21]
Xu, Y.; Gabriel, K.; Wang, Y.; Zhou, Y.; Eisele, O.; Vutikullird, A.; Mikol, D.D.; Lee, E.; Multi-Center, A. A multi-center, open-label, pharmacokinetic drug interaction study of erenumab and a combined oral contraceptive in healthy females. CNS Drugs, 2019, 33(5), 513-522.
[http://dx.doi.org/10.1007/s40263-019-00626-2] [PMID: 30963506]
[22]
de Hoon, J.; Van Hecken, A.; Vandermeulen, C.; Herbots, M.; Kubo, Y.; Lee, E.; Eisele, O.; Vargas, G.; Gabriel, K. Phase 1, randomized, parallel-group, double-blind, placebo-controlled trial to evaluate the effects of erenumab (AMG 334) and concomitant sumatriptan on blood pressure in healthy volunteers. Cephalalgia, 2019, 39(1), 100-110.
[23]
Lipton, R.B.; Tepper, S.J.; Silberstein, S.; Kudrow, D.; Ashina, M.; Reuter, U.; Dodick, D.; Zhang, F.; Rippon, G.A.; Mikol, D.D. Conversion from chronic to episodic migraine with erenumab, a specific inhibitor of the calcitonin gene-related peptide receptor. J. Headache Pain, 2018, 19.
[24]
Lipton, R.; Tepper, S.; Silberstein, S.; Kudrow, D.; Ashina, M.; Reuter, U.; Dodick, D.; Cheng, S.; Rippon, G.; Zhang, F. Conversion from chronic migraine (CM) to episodic migraine (EM) with long-term erenumab treatment. Neurology, 2019, 92(15)(Suppl)
[25]
Christensen, C.E.; Younis, S.; Deen, M.; Khan, S.; Ghanizada, H.; Ashina, M. Migraine induction with calcitonin gene-related peptide in patients from erenumab trials. J. Headache Pain, 2018, 19(1), 105.
[http://dx.doi.org/10.1186/s10194-018-0927-2] [PMID: 30409109]
[26]
Diener, H.C.; Ashina, M.; Brandes, J.; Friedman, D.; Reuter, U.; Tepper, S.; Cheng, S.; Leonardi, D.; Lenz, R.; Mikol, D. Efficacy of erenumab for the treatment of patients with chronic migraine in presence of medication overuse. Eur. J. Neurol., 2017, 24, 472.
[27]
Dodick, D.; Tepper, S.; Diener, H.C.; Tassorelli, C.; Lucas, S.; Evers, S.; Zhang, F.; Chou, D.; Tenenbaum, N.; Klatt, J. Efficacy of erenumab in chronic migraine patients with medication overuse and prior preventive treatment failure. Eur. J. Neurol., 2019, 26, 811.
[28]
Tepper, S.; Diener, H.C.; Ashina, M.; Brandes, J.L.; Friedman, D.T.; Reuter, U.; Cheng, S.; Leonardi, D.; Lenz, R.; Mikol, D. Efficacy of erenumab for the treatment of patients with chronic migraine in presence of medication overuse. Schmerz, 2017, 31(2), S66.
[29]
Tepper, S.J.; Diener, H.C.; Ashina, M.; Brandes, J.L.; Friedman, D.I.; Reuter, U.; Cheng, S.; Nilsen, J.; Leonardi, D.K.; Lenz, R.A.; Mikol, D.D. Erenumab in chronic migraine with medication overuse: Subgroup analysis of a randomized trial. Neurology, 2019, 92(20), e2309-e2320.
[http://dx.doi.org/10.1212/WNL.0000000000007497] [PMID: 30996056]
[30]
Lipton, R.B.; Brennan, A.; Palmer, S.; Hatswell, A.J.; Porter, J.K.; Sapra, S.; Villa, G.; Shah, N.; Tepper, S.; Dodick, D. Estimating the clinical effectiveness and value-based price range of erenumab for the prevention of migraine in patients with prior treatment failures: A US societal perspective. J. Med. Econ., 2018, 21(7), 666-675.
[http://dx.doi.org/10.1080/13696998.2018.1457533] [PMID: 29571276]
[31]
Ohlsson, L.; Haanes, K.A.; Kronvall, E.; Xu, C.; Snellman, J.; Edvinsson, L. Erenumab (AMG 334), a monoclonal antagonist antibody against the canonical CGRP receptor, does not impair vasodilatory or contractile responses to other vasoactive agents in human isolated cranial arteries. Cephalalgia, 2019, 39(14), 1745-1752.
[32]
Tepper, S.J.; Pascual, J.; Reuter, U.; Picard, H.; Hong, F.; Trotman, M.L.; Xue, F.; Mikol, D.; Klatt, J. Analysis of blood pressure following short-term and long-term treatment with erenumab. J. Headache Pain, 2018, 90(15)(Suppl.)
[33]
Kudrow, D.; Pascual, J.; Winner, P.K.; Dodick, D.W.; Tepper, S.J.; Reuter, U.; Hong, F.; Klatt, J.; Zhang, F.; Cheng, S.; Picard, H.; Eisele, O.; Wang, J.; Latham, J.N.; Mikol, D.D. Vascular safety of erenumab for migraine prevention. Neurology, 2020, 94(5), e497-e510.
[http://dx.doi.org/10.1212/WNL.0000000000008743] [PMID: 31852816]
[34]
Depre, C.; Antalik, L.; Starling, A.; Koren, M.; Eisele, O.; Lenz, R.A.; Mikol, D.D.A. Randomized, double-blind, placebo-controlled study to evaluate the effect of erenumab on exercise time during a treadmill test in patients with stable angina. Headache, 2018, 58(5), 715-723.
[http://dx.doi.org/10.1111/head.13316] [PMID: 29878340]
[35]
Balfagón, G.; Márquez-Rodas, I.; Alvarez, Y.; Alonso, M.J.; Cachofeiro, V.; Salaices, M.; Lahera, V. Aldosterone modulates neural vasomotor response in hypertension: role of calcitonin gene-related peptide. Regul. Pept., 2004, 120(1-3), 253-260.
[http://dx.doi.org/10.1016/j.regpep.2004.03.016] [PMID: 15177944]
[36]
Tepper, S.; Ashina, M.; Reuter, U.; Brandes, J.L.; Doležil, D.; Silberstein, S.; Winner, P.; Leonardi, D.; Mikol, D.; Lenz, R. Safety and efficacy of erenumab for preventive treatment of chronic migraine: A randomised, double-blind, placebo-controlled phase 2 trial. Lancet Neurol., 2017, 16(6), 425-434.
[http://dx.doi.org/10.1016/S1474-4422(17)30083-2] [PMID: 28460892]
[37]
Ashina, M.; Dodick, D.; Goadsby, P.J.; Reuter, U.; Silberstein, S.; Zhang, F.; Gage, J.R.; Cheng, S.; Mikol, D.D.; Lenz, R.A. Erenumab (AMG 334) in episodic migraine: Interim analysis of an ongoing open-label study. Neurology, 2017, 89(12), 1237-1243.
[http://dx.doi.org/10.1212/WNL.0000000000004391] [PMID: 28835404]
[38]
Ashina, M.; Kudrow, D.; Reuter, U.; Dolezil, D.; Silberstein, S.; Tepper, S.J.; Xue, F.; Picard, H.; Zhang, F.; Wang, A.; Zhou, Y.; Hong, F.; Klatt, J.; Mikol, D.D. Long-term tolerability and nonvascular safety of erenumab, a novel calcitonin gene-related peptide receptor antagonist for prevention of migraine: A pooled analysis of four placebo-controlled trials with long-term extensions. Cephalalgia, 2019, 39(14), 1798-1808.
[39]
Ashina, M.; Goadsby, P. J.; Reuter, U.; Silberstein, S.; Dodick, D.; Rippon, G. A.; Klatt, J.; Xue, F.; Chia, V.; Zhang, F.; Cheng, S.; Mikol, D. D. Long-term safety and tolerability of erenumab: Threeplus year results from a five-year open-label extension study in episodic migraine. Cephalalgia, Cephalalgia, 2019, 39(1455), 1455-1464.

Rights & Permissions Print Cite
Article Metrics
36
2
World Autism Awareness Day
© 2024 Bentham Science Publishers | Privacy Policy