Abstract Details

To report the first Italian, multicenter, real-life study with erenumab in the prevention of high frequency episodic (HFEM: 9-14 days/month) and chronic migraine (CM).

We treated 372 migraine patients with >1 erenumab 70 mg dose (HFEM:103 pts; CM: 269 pts). Mean prior therapeutic failures were 3.7 (HFEM) and 5.2 (CM). At week 12, erenumab induced a meaningful reduction in MMDs, MAI, VAS, and HIT-6 in patients with HFEM (-3.5, -6.5, -1.8, -10.5) and in those with CM (− 12.7, -12.9, - 2.6, -12.9). Among patients with HFEM, >50% responders were 63.8%, ≥ 75% responders 15.9% and 100% responders 2.9% and among subjects with CM 66.3%, 25% and 1.3%, respectively. The increase of the erenumab dose to 140 mg in 73 patients for inefficacy or efficacy wear-off proved effective in 69.9% of cases. Adverse events were uncommon (13.1%), mild or moderate, constipation being the most frequent one (9.1%). 

In a real-life population of patients with HFEM and CM and multiple prior therapeutic failures erenumab 70 mg is more effective in terms of >50% response rate than reported in RCTs (HFEM: 63.8% vs 43%, CM: 66.3% vs 40%) and also largely outperforms the >50 response rate with the dose of 140 mg in patients with multiple therapeutic failures (LIBERTY trial: 30%). We confirm that erenumab is safe and well tolerated.