Erenumab not effective at reducing pain in trigeminal neuralgia

Erenumab was not effective in reducing pain intensity in patients with trigeminal neuralgia, researchers reported in Lancet Neurology.

Trigeminal neuralgia is a severe facial pain disorder that is difficult to treat. It is the most common facial pain neuralgia, and there are currently no treatments for the disorder, Anne Sofie Schott Andersen, MD, of the Danish Headache Center at Copenhagen University in Denmark, and colleagues wrote.

Andersen and colleagues conducted a randomized, double-blind, placebo-controlled trial in adults aged 18 to 85 years with idiopathic classic trigeminal neuralgia to evaluate the safety and efficacy of erenumab.

Participants were included if they reported a pain intensity score of at least 4 on the 11-point Numeric Rating Scale and had at least three daily pain paroxysms. Participants were randomly assigned at a 1:1 ratio to receive subcutaneous injections of either 140 mg of erenumab or placebo. Forty received erenumab and 40 received placebo.

The primary outcome was a reduction of at least 30% in the mean average daily pain intensity score.

After 4 weeks, there was no difference between the two groups in mean average daily pain intensity score or a decrease in the number of paroxysms (17 of 40 in the erenumab group [43%] vs. 21 of 40 in the placebo [53%]).

In both groups, 20 of the 40 participants reported adverse events. The most common adverse events were constipation (28%) and headache (10%) in the erenumab group, and headache (13%), constipation (10%) and abdominal pain (10%) in the placebo group.

“Erenumab did not reduce pain intensity or the number of paroxysms compared with placebo in patients with trigeminal neuralgia,” the authors wrote. “[Calcitonin gene-related peptide] is unlikely to have a role in the transmission of the pain in trigeminal neuralgia.”