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Aimovig users experience mixed results
PHILADELPHIA — Aimovig, the monthly self-injectable, FDA-approved treatment for preventing migraines, had limited benefits in some patients but favorable responses in others, according to abstracts and presentations from the American Headache Society Annual Scientific Meeting.
Stewart J. Tepper, MD, professor of neurology at the Dartmouth Geisel School of Medicine and colleagues reviewed data from 375 patients prescribed Aimovig (erenumab; Novartis, Amgen).
They found that 76% of 188 patients with chronic migraine who received the 70-mg dose and 72% of 187 patients with chronic migraine prescribed the 140-mg dose did not report a response of 50% or greater at month 1. In addition, 49% of those who received the 70-mg dose and 70% of those who received the 140-mg dose went on to have a 50% or greater response for months 2 and 3. Also, 18% of those who received the 70-mg dose and 32% of those who received the 140-mg dose went on to have a 75% or greater response throughout all 3 months.
“The results of our analysis support recent guidance from the American Headache Society that recommends 3 months of assessment following initiation of migraine preventive treatment,” researchers wrote.
Results from other erenumab studies presented at the meeting include:
- 210 patients who received the 70-mg dose, and 205 patients who were prescribed the 140-mg dose reported no initial response; however, with continued treatment, 86 of reported 70-mg users and 98 of reported 140-mg users responded by the third month, and 128 of reported 70-mg users and 140 of reported140-mg users responded by the sixth month.
- 17 of 190 patients who received a monthly dose of 140 mg reported that the drug lost its effectiveness during the first month of treatment, prompting researchers to suggest switching such patients to receiving the 70-mg dose every 14 days.
- 539 patients with suspected allodynia reported that the drug was effective.
- 32 patients who received the 70-mg dose to supplement onabotulinumtoxinA had 3.1 fewer mean migraine days after 60 days; 35 patients who received 140 mg to take in combination with onabotulinumtoxinA experienced 11.5 fewer mean migraine days after the same period of time.
- Of the 64,439 patients prescribed the drug between May 1, 2018 and Oct. 31, 2018, 65.2% received a 70-mg dose and of those, 85% were women with an average age of 48 years.
- A 4-plus year interim analysis of a 5-year open-label treatment period of 221 patients with episodic migraine who received a monthly 70-mg dose of ereneumab and then approximately 2 years later switched to a monthly 140-mg dose showed these patients experienced "sustained reductions" in their migraine frequency.
- 228 patients with episodic migraine whose previous treatment attempts had been unsuccessful and then received a 140-mg dose of erenumab experienced sustained efficacy throughout 24 weeks.
The FDA approved erenumab, a calcitonin gene-related peptide blocker to prevent migraine that is received through injection, last year. The agency also approved of Ajovy and Emgality, two other drugs of the same design and purpose, by the end of the year. – by Janel Miller
References:
A retrospective analysis to evaluate the response of the addition of erenumab to onabotulinumtoxinA for the prevention of intractable chronic migraine without aura. Submission ID: 682169
Erenumab prescription early view: Patient characteristics, treatment patterns and medication adherence in the United States. Submission ID: 678603
Ashina M. Sustained efficacy and long-term safety of erenumab in patients with episodic migraine: 4+ year results of a 5-year, open-label extension study.
Lipton R, et al. Efficacy of erenumab in chronic migraine patients with and without allodynia.
McAllister P, et al. Temporal response patterns to erenumab in patients with episodic migraine.
Naveen G. The Aimovig “wear-off”: A retrospective case series of response to 14-day dosing. Submission ID: 666255
Tepper SJ, et al. Sustained response to erenumab over time in patients with chronic migraine.
Tepper SJ, et al. Temporal response patterns to erenumab in patients with chronic migraine.
Uwe R, et al. Assessment of the efficacy of erenumab during the open-label treatment (13 to 24 weeks) of subjects with episodic migraine who failed two to four prior preventive treatments: results of the LIBERTY study.
All presented at: American Headache Society Annual Scientific Meeting; July 11-14, 2019; Philadelphia.
Disclosures: Healio Primary Care was unable to determine the authors’ relevant financial disclosures prior to publication.