Abstract
Erenumab is the first human monoclonal antibody to be approved as a selective therapy for migraine prophylaxis in adults. This study assessed, in a real-world setting, the efficacy of erenumab and its impact on the quality of life (QoL) of Cypriot migraine patients who had failed several treatments in the past. Erenumab was prescribed as a stand-alone or as an add-on therapy to 16 patients with chronic migraine. The first component of the study examined migraine parameters before and after erenumab therapy and included an interim 3-month subjective assessment. In the second component, the patients were asked to complete the validated Migraine-Specific Quality-of-Life Questionnaire—Version 2.1 (MSQ V2.1) during the last month of their individual treatment as a measure of the QoL. The results showed a statistically significant improvement in almost all migraine parameters following erenumab treatment. In the 3-month-interval assessment, 81.3% of the patients reported an improvement in their mental well-being, anxiety, and depression levels, with more than 80% of the patients reporting an improvement in almost all assessed migraine parameters. MSQ V2.1 indicated a good health status in all three domains (mean values > 60 on a scale 0–100), with the “role function preventative” domain having the highest health scores (85). Over a period of 6 months, erenumab was safe, well-tolerated, and effective in preventing migraine symptoms and improving HR-QoL. We conclude that this novel medication, which is not yet part of the national formulary in Cyprus, may be a cost-effective solution in reducing the disease burden of chronic migraine.
Highlights
Migraine is one of the four most common causes of disability worldwide according to the World Health Organization [1, 2]
The available treatments for migraine have included non-specific oral prophylactic medications such as anti-epileptic drugs, tricyclic antidepressants (TCAs), beta-blockers, calcium channel blockers, and selective serotonin reuptake inhibitors (SSRIs) among others as well as injectable therapies, like botulinum toxin, that were approved for Erenumab and quality of life (QoL) in Migraine the treatment of other conditions and were later repurposed as migraine treatments [3]
Erenumab was prescribed as a stand-alone therapy for four patients (25.0%) and as an add-on therapy for 12 patients (75%): seven patients (43.8%) were on one additional preventative medication, while five patients (31.3%) were on two concurrent preventative medications at the onset of erenumab treatment
Summary
Migraine is one of the four most common causes of disability worldwide according to the World Health Organization [1, 2]. The available treatments for migraine have included non-specific oral prophylactic medications such as anti-epileptic drugs, tricyclic antidepressants (TCAs), beta-blockers, calcium channel blockers, and selective serotonin reuptake inhibitors (SSRIs) among others as well as injectable therapies, like botulinum toxin, that were approved for Erenumab and QoL in Migraine the treatment of other conditions and were later repurposed as migraine treatments [3] They are used alone or in combination, with variable efficacy and tolerability often leading to decreased compliance, frequent medication switching, and overuse of acute migraine medication [4, 5]. Over-the-counter medications include codeine-containing formulations and contribute to the high prevalence of medication-overuse headache (MOH; defined as the use of pain relief medications alone or in any combination for at least 10 days per month or more) [7]
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