Erenumab Dosage for Migraine Prevention

An Evidence-Based Narrative Review With Recommendations

Stewart J. Tepper MD; Huma U. Sheikh MD; Carrie O. Dougherty MD; Stephanie J. Nahas MD MSEd; Paul K. Winner DO; Ananda Krishna Karanam PhD; Andrew M. Blumenfeld MD; Ahmad Abdrabboh PharmD MPH; Soeren Rasmussen MD; Jamie L. Weiss PhD; Jessica Ailani MD

Disclosures

Headache. 2022;62(4):420-435. 

In This Article

Overview of Erenumab Studies

From the literature search, we retrieved 23 relevant articles/conference abstracts that fulfilled the above pre-defined eligibility criteria enabling us to discern any differences between the two doses. Most were related to the STudy to evaluate the efficacy and safety of erenumab in migRaIne preVEntion (STRIVE) study[10] and the registrational Phase 2 pivotal CM study.[11] The erenumab studies are summarized in Table 3, and characteristics of key studies are available in Table 4. Other studies retrieved included a Phase 2 EM study (ClinicalTrials.gov, number NCT01952574)[20] of erenumab. This study established a dose–response relationship in participants with EM, and provided Class 1b evidence that erenumab 70 mg has potential for prevention of migraine, supporting its further development in a Phase 3 study. Participants who completed the 12-week parent study double-blind treatment phase (DBTP)[20] entered an ongoing OLE of up to 5 years during which they initially received 70 mg. Following a protocol amendment after ~2 years, the dosage of erenumab was increased to 140 mg. The long-term efficacy and safety data of erenumab from the interim analysis is available for 4-plus years of the 5-year OLE.[21–23]

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