Umberto Pensato1, Carlo Baraldi2, Valentina Favoni3, Maria Michela Cainazzo2, Paola Torelli4,5, Pietro Querzani6, Alessia Pascazio1, Davide Mascarella1, Eleonora Matteo1, Simone Quintana4,5, Gian Maria Asioli1, Pietro Cortelli1,3, Giulia Pierangeli1,3, Simona Guerzoni2, Sabina Cevoli7. 1. Department of Biomedical and NeuroMotor Sciences of Bologna, University of Bologna, Bologna, Italy. 2. Medical Toxicology-Headache and Drug Abuse Research Centre, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy. 3. IRCCS Istituto Delle Scienze Neurologiche Di Bologna, Bologna, Italy. 4. Headache Centre, University Hospital of Parma, AOUPR, Parma, Italy. 5. Department of Medicine and Surgery, University of Parma, Parma, Italy. 6. Neurology Unit, S. Maria Delle Croci Hospital-AUSL Romagna, Ravenna, Italy. 7. IRCCS Istituto Delle Scienze Neurologiche Di Bologna, Bologna, Italy. sabina.cevoli@unibo.it.
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.
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.
Authors: Henri Autio; Timo Purmonen; Samu Kurki; Emina Mocevic; Minna A Korolainen; Samuli Tuominen; Mariann I Lassenius; Markku Nissilä Journal: Neurol Ther Date: 2021-12-10
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