Learn more about this new option for people who have frequent attacks of migraine

Injections of erenumab have recently been added to the list of drugs used for prophylaxis of frequent migraine attacks.

The drug is listed as Schedule 4 by the TGA.

Other options for migraine treatment include amitriptyline, pizotifen and propranolol, explains a new alert from Australian Prescriber, a publication of NPS MedicineWise.

Erenumab is a monoclonal antibody against the calcitonin gene-related peptide (CGRP) receptor.

After subcutaneous injection the peak concentration of erenumab is reached after 4–6 days. The effective half-life is 28 days, so monthly injections are recommended.

In its approved indication of migraine prophylaxis, erenumab is significantly more effective than placebo, explains the publication which looked into the results of three clinical trials.

One 2017 controlled trial of erenumab for episodic migraine published in the New England Journal of Medicine found the drug administered subcutaneously at a monthly dose of 70 mg or 140 mg significantly reduced migraine frequency, the effects of migraines on daily activities, and the use of acute migraine–specific medication over a period of 6 months.

However the researchers said the long-term safety and durability of the effect of erenumab require further study. 

All three clinical trials that were reviewed received funding from Amgen and Novartis – the manufacturers of erenumab.

Australian Presciber adds that erenumab will not benefit everyone.

“Less than half the patients injecting 70 mg monthly will get a 50% or greater reduction in the number of days they have migraine,” says Australian Prescriber.

“Initially erenumab is likely to be tried in people who have not benefited from other drugs.

“A monthly injection could overcome some of the problems with adhering to a prophylactic regimen, but the long-term effectiveness of erenumab needs to be established.”

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