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Real-life assessment of erenumab in refractory chronic migraine with medication overuse headache

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Abstract

Objective

To determine whether erenumab is effective and safe in refractory chronic migraine with medication overuse headache.

Methods

In this prospective, multicentric, real-life study, chronic migraine with medication overuse headache patients who received erenumab were recruited. Study inclusion was limited to patients who previously failed onabotulinumtoxinA in addition to at least three other pharmacological commonly used migraine preventive medication classes.

Results

Of 396 patients who received erenumab, 38% (n = 149) met inclusion criteria. After 3 months, 51% (n = 76) and 20% (n = 30) patients achieved ≥ 50% and ≥ 75% reduction in monthly headache days, respectively. Monthly pain medications intake decreased from 46.1 ± 35.3 to 16.8 ± 13.9 (p < 0.001), while monthly headache days decreased from 25.4 ± 5.4 to 14.1 ± 8.6 (p < 0.001). Increasing efficacy of erenumab over the study period was observed. Allodynia was a negative predictive factor of erenumab response (odds ratio = 0.47; p = 0.03). Clinical conversion to episodic migraine with no medication overuse was observed in 64% (n = 96) patients. No serious adverse events were observed.

Conclusions

Erenumab reduced significantly migraine frequency and pain medication intake in refractory chronic migraine with MOH patients.

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Data availability

The authors take full responsibility for the data, the analysis, and interpretation of the research, and they have full access to all of the data.

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Acknowledgements

We would like to thank Cecilia Baroncini who edited the English text.

Author information

Author notes

  1. Authors Umberto Pensato and Carlo Baraldi contributed equally to this work.

Authors and Affiliations

  1. Department of Biomedical and NeuroMotor Sciences of Bologna, University of Bologna, Bologna, Italy

    Umberto Pensato, Alessia Pascazio, Davide Mascarella, Eleonora Matteo, Gian Maria Asioli, Pietro Cortelli & Giulia Pierangeli

  2. Medical Toxicology-Headache and Drug Abuse Research Centre, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy

    Carlo Baraldi, Maria Michela Cainazzo & Simona Guerzoni

  3. IRCCS Istituto Delle Scienze Neurologiche Di Bologna, Bologna, Italy

    Valentina Favoni, Pietro Cortelli, Giulia Pierangeli & Sabina Cevoli

  4. Headache Centre, University Hospital of Parma, AOUPR, Parma, Italy

    Paola Torelli & Simone Quintana

  5. Department of Medicine and Surgery, University of Parma, Parma, Italy

    Paola Torelli & Simone Quintana

  6. Neurology Unit, S. Maria Delle Croci Hospital-AUSL Romagna, Ravenna, Italy

    Pietro Querzani

Authors
  1. Umberto Pensato
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  2. Carlo Baraldi
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  3. Valentina Favoni
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  4. Maria Michela Cainazzo
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  7. Alessia Pascazio
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  11. Gian Maria Asioli
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  15. Sabina Cevoli
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Contributions

UP and CB analyzed the data and drafted the manuscript; VF, MMC, PT, AP, DM, EM, SQ, GMA, PC, GP, SG, and SC acquired and analyzed data, and critically revised the manuscript. SC conceived and designed the study.

Corresponding author

Correspondence to Sabina Cevoli.

Ethics declarations

Ethics approval

The study was approved by an independent ethics committee or local institutional review board at each participating site, and written informed consent was obtained from all enrolled patients. All clinical investigations were conducted according to the latest version of the Declarations of Helsinki.

Consent to participate

Written informed consent was collected from the patients for the inclusion of deidentified clinical data in a scientific publication, in accordance with the Declaration of Helsinki.

Consent for publication

All authors agreed with this final version.

Conflict of interest

Carlo Baraldi and Simona Guerzoni received travel grants and honorary from Allergen, Novartis, Teva, and Ely Lilly. Maria Michela Cainazzo received travel grants and honorary from Allergen, Novartis, IBSA, and Ely Lilly. Sabina Cevoli received travel grants, honoraria for advisory boards, speaker panels, or clinical investigation studies from Novartis, Teva, Lilly, Allergan, Ibsa, and Lundbeck. Valentina Favoni received honoraria as a speaker or for participating in advisory boards from Ely-Lilly, Novartis, and Teva. The other authors declare that they have no competing interests.

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Pensato, U., Baraldi, C., Favoni, V. et al. Real-life assessment of erenumab in refractory chronic migraine with medication overuse headache. Neurol Sci 43, 1273–1280 (2022). https://doi.org/10.1007/s10072-021-05426-5

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  • DOI: https://doi.org/10.1007/s10072-021-05426-5

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