Migraine

An assessment reveals that a newly approved antibody treatment; to treat migraines seems to be ineffective among patients who suffer from high-frequency migraines. The findings will be present during the 61st annual scientific meeting of the American Headache Society in Philadelphia.

Migraine is a primary headache disorder characterize by recurrent headaches that are moderate to severe.Typically, the headaches affect one half of the head, are pulsating in nature, and last from two to 72 hours. Associated symptoms may include nausea, vomiting, and sensitivity to light, sound, or smell. The pain is generally made worse by physical activity.

Migraines typically present with self-limited, recurrent severe headache associate with autonomic symptoms. About 15–30% of people with migraines experience migraines with an aura and those who have migraines with aura also frequently have migraines without aura.

Erenumab is approve for migraine in adults

Erenumab  is a medication which targets the calcitonin gene-related peptide receptor (CGRPR); for the prevention of migraine. It was the first of the group of CGRPR antagonists to be FDA approve in 2018. It is a form of monoclonal antibody therapy in which specially culture antibodies are use to stimulate the patient’s immune system into attacking the receptors for the protein CGRP, thought to play a major role in starting migraines.

Erenumab is approve for prevention of migraine in adults. It is administer by subcutaneous injection of 70 or 140 mg once a month. Erenumab is a fully humanize monoclonal antibody blocking the calcitonin gene-related peptide receptor (CGRPR).

Clinicians at OHSU in Portland, Oregon, conduct a retrospective chart review of 28 patients who prescribe 70 miligrams of Erenumbab per month for three months beginning in June of 2018. Each of the patients report 25 or more headache days per month when they began the treatment.

High-frequency patients

Given the relatively high cost of the new antibody treatment a list price of $6,900 clinical care at OHSU has focused on prescribing it for patients with incapacitating and frequent migraines. They hope to reduce the number of headaches by at least half through once-monthly self-injections.

None of the high-frequency patients achieved a 50 % reduction in headache frequency, although six patients report a reduction of at least 25 %. Common side effects are constipation, pruritus, muscle spasms, as well as mild and mostly transient reactions at the injection site.

“In a climate where financial constraint cannot be ignore, when possible use of new medications should be tailor as specifically as possible to limit waste of a finite resource,” said Juliette Preston, M.D., director of the OHSU headache center and assistant professor of medicine in the OHSU School of Medicine.