__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
Aimovig is indicated for prophylaxis of migraine in adults who have at least 4 migraine days per month.1
More than one billion people worldwide suffer with migraines.2 Despite a broad range of available treatments, preventive medications have low adherence and high discontinuation rates.3
NICE recommendation4
Erenumab is recommended as an option for preventing migraine in adults, only if:
- they have 4 or more migraine days a month
- at least 3 preventive drug treatments have failed
- the 140 mg dose of erenumab is used and
- the company provides it according to the commercial arrangement
Stop erenumab after 12 weeks of treatment if:
- in episodic migraine (less than 15 headache days a month) the frequency does not reduce by at least 50%
- in chronic migraine (15 headache days a month or more with at least 8 of those having features of migraine) the frequency does not reduce by at least 30%
According to the SmPC, The recommended dose is 70 mg erenumab every 4 weeks. Some patients may benefit from a dose of 140 mg every 4 weeks.1
Aimovig demonstrated superiority vs standard of care (SoC) topiramate in the number of patients achieving a ≥50% reduction in monthly migraine days (p<0.001)
(HER-MES trial, Germany)*5
HER-MES was a 24-week, randomised, double-blind, double-dummy, controlled trial conducted in 82 sites in Germany (n=777).5
Secondary endpoint: Significantly more patients achieved a ≥50% reduction in monthly migraine days from baseline with erenumab vs topiramate (55.4% vs 31.2%: odds ratio 2.76; 95% confidence interval 2.06, 3.71; p<0.001 [monthly migraine days at baseline were 10.3 in the erenumab group vs 10.5 in the topiramate group]).5
Aimovig is the first anti-calcitonin gene-related peptide (CGRP) with proven efficacy in a head-to-head trial with SoC topiramate.5
Efficacy maintained for up to 5 years6
The efficacy and safety profile of Aimovig was evaluated in a 5-year, open-label study, which followed a preceding 12-week double-blind treatment period in patients with episodic migraine.6
The mean (standard error, SE) change in MMDs from a baseline of 8.7 (0.2) days was -5.3 (0.3) days; an average reduction of 62.3% at year 5.6
The proportions of patients with ≥50%/≥75%/100% reduction in MMDs were maintained throughout the 5-year open-label treatment period with response rates of 71.0%/47.1%/35.5%, respectively, over the last 4-week period.6
Among patients using AMSM at baseline, mean (SE) baseline usage was 6.2 (0.2) treatment days. Mean change from baseline with erenumab was -4.4 (0.3) days over the last 4-week period at week 268.6
*German trial, no UK patients took part in this study.
AMSM, acute migraine-specific medication; CGRP, calcitonin gene-related peptide; CI, confidence interval; MMD, monthly migraine days; NICE, National Institute of Health and Care Excellence; PEP, primary end point; SE, standard error; SmPC, Summary of Product Characteristics; SoC, standard of care; TPM, topiramate.
References
- Aimovig® (erenumab) Summary of Product Characteristics.
- Goadsby PJ, et al. Physiol Rev 2017;97(2):553-622.
- Hubig LT, et al. Headache 2022;62)9):1187-1197.
- National Institute for Health and Care Excellence. Erenumab for preventing migraine. Available at: https://www.nice.org.uk/guidance/ta682/chapter/1-Recommendations [Accessed March 2024].
- Reuter U, et al. Cephalalgia 2022;42(2):108–118.
- Ashina M, et al. EurJNeurol 2021;28(5):1716-1725.
