Aimovig (erenumab-aooe) / Amgen, Novartis - LARVOL DELTA

A Semi-Mechanistic Mathematical Model of Immune Tolerance Induction to Support Preclinical Studies of Human Monoclonal Antibodies in Rats. (PubMed, Pharmaceutics) - "To mitigate this effect, we have recently performed and reported on studies using short-term immunosuppressive regimens to induce prolonged immune tolerance towards a human mAb, erenumab, in rats. It also successfully captured the impact of tacrolimus/sirolimus immunomodulation on ADA formation, demonstrating that the regimen effectively suppressed ADA formations and induced immune tolerance. This work demonstrates the utility of modeling approaches to integrate pharmacokinetic and immunogenicity assessment data for the prospective planning of long-term toxicology studies to support the preclinical development of mAbs."

Journal • Preclinical • Immunology • CD4

The state of insurance coverage of calcitonin gene-related peptide-targeted medications and its impact on the implementation of the American Headache Society's 2024 consensus statement: An interrupted time-series analysis. (PubMed, Headache) - "Ten months after the American Headache Society's March 2024 consensus statement made the CGRP-targeted medications first-line for the prevention of migraine, insurance companies have had incomplete compliance with the recommendations, potentially limiting the full impact of the AHS' consensus statement on the utilization of the CGRP-targeted therapies."

Journal • Reimbursement • US reimbursement • CNS Disorders • Migraine • Pain

Calcitonin gene-related peptide monoclonal antibody treatment for new daily persistent headache. (PubMed, J Headache Pain) - "CGRP mAbs were effective in approximately 1/4 patients with treatment-refractory NDPH,but less likely to be effective in NDPH than CM. This suggests that NDPH cannot be seen as equivalent to CM and that new treatment options are required for this highly disabling disorder."

Journal • CNS Disorders • Migraine • Pain

Cost-effectiveness of abortive and preventative treatments in patients with migraine: a systematic review. (PubMed, Eur J Clin Pharmacol) - "Economic evaluations underscore the clinical benefits of novel migraine therapies but reveal price challenges, particularly in resource-limited settings. Biosimilar adoption and head-to-head cost comparisons are essential to improving access. Tailoring migraine management strategies to regional economic contexts remains critical to achieving sustainable and equitable care."

HEOR • Journal • Review • Anesthesia • CNS Disorders • Migraine • Pain

Calcitonin Gene-Related Peptide Antagonist Use and Atypical Femur Fractures: A Case Report. (PubMed, JBJS Case Connect) - "Erenumab is a CGRP antagonist, which increases bone formation, and may be associated with atypical femur fractures. Further investigations are warranted."

Journal • CNS Disorders • Migraine • Musculoskeletal Diseases • Orthopedics • Osteoporosis • Pain • Rheumatology

Tolerability of switch from erenumab to fremanezumab in adults with chronic migraine: a 3-month, single-center, prospective, real-world, observational study. (PubMed, J Headache Pain) - No abstract available

Journal • Observational data • Real-world evidence • CNS Disorders • Constipation • Gastroenterology • Gastrointestinal Disorder • Migraine • Pain

CACS: Clinical advantages of cGRPi switch, a retrospective observational study (AHS 2025) - "The advent of calcitonin gene-related peptide (CGRP) antagonists—such as erenumab (a receptor blocker) and galcanezumab, fremanezumab, eptinezumab (ligand blockers)—offers a novel targeted approach. CGRP antagonists demonstrate efficacy in managing migraines but require better data collection and patient monitoring to optimize outcomes. Continuous monitoring, personalized treatment strategies, and further research are necessary to improve clinical decision-making and healthcare efficiency. FIGURE 1."

Observational data • Retrospective data • CNS Disorders • Migraine • Pain

Retention rates across clinical trials of anti-CGRP monoclonal antibodies for migraine prevention (AHS 2025) - "Similar trials with other anti-CGRP mAbs relative to PREVAIL (ie, long-term [≥48-week] trials in chronic migraine [CM]) were included: REGAIN (galcanezumab), phase 2 trial (erenumab) and HALO CM (fremanezumab). Eptinezumab demonstrated high, long-term retention rates for preventive treatment in participants with CM and in those with migraine for whom 2-4 prior migraine preventive treatments have failed. These findings suggest a high level of participant satisfaction with continued treatment of eptinezumab."

Clinical • CNS Disorders • Migraine • Pain

Headphone headache (AHS 2025) - "She noted that her migraines worsened with the development of scalp allodynia where she became refractory to several pharmaceutical treatments including propranolol, cyproheptadine, amitriptyline, nortriptyline, topiramate, zonisamide, venlafaxine, erenumab, galcanezumab, and magnesium infusions. One case is described in which pain associated with external compression headache in the setting of prolonged headphone use was decreased by onabotulinum toxin injections. We hypothesize that, similar in the treatment of migraine, onabotulinum toxin may work to dampen the central sensitization of the sensory neurons associated with allodynia. More research is necessary to confirm our findings."

CNS Disorders • Depression • Migraine • Musculoskeletal Pain • Pain • Psychiatry

Erenumab for Chronic Cluster Headache: A Randomized Clinical Trial. (PubMed, JAMA Netw Open) - P2 | "Future studies should revisit the role of CGRP in CCH. ClinicalTrials.gov Identifier: NCT04970355; EudraCT Number: 2020-004399-16."

Clinical • Journal • Chronic Cluster Headache • Pain

Real world evidence for risk-averse behavior in the prescribing of calcitonin gene-related peptide monoclonal antibodies by headache specialists for the prevention of migraine: A retrospective, cohort study (AHS 2025) - "In an open-label extension study of erenumab 2/383 (0.7%) patients reported a cardiovascular event and no patients reported a cerebrovascular event in a 5 year follow up period (Ashina 2019). Other studies evaluating CGRP mAbs, such as galcanezumab and fremanezumab, are reassuring but largely limited to 1–2 year follow up studies (Yang 2025)...Patients were matched for sex, age, high cholesterol (denoted by an ICD-10 code of E78), diabetes mellitus (ICD-10 codes E10 and E11), onabotulinumtoxin A prescriptions, and duration in database... In our cohort of patients, individuals who received CGRP mAbs were overall less likely to be subsequently diagnosed with HTN, CVA, MI, or constipation, with the lowest rates in the CGRP mAb group prescribed by a headache provider and higher in in the group prescribed a CGRP mAb by a non-headache neurologist. These results suggest that headache providers may be more cognizant of the potential risks and complications of these medications...."

HEOR • Real-world • Real-world evidence • Retrospective data • CNS Disorders • Migraine • Pain

Dual calcitonin gene-related peptide antagonists for chronic migraine prevention (AHS 2025) - "These medications are divided into monoclonal antibodies, "-mAbs" (erenumab, fremanezumab, galcanezumab, and eptinezumab) and small molecule "-gepants" (rimegepant and atogepant)...Common prior or concurrent non-CGRP antagonist migraine preventive medications included topiramate (84%), tricyclic antidepressants (76%), and onabotulinumtoxinA (73%)... In our small sample, dual preventive CGRP antagonist use was well-tolerated and may be considered for patients with chronic migraine who are resistant to usual treatment. However, larger studies are needed to confirm the safety and efficacy of this approach."

CNS Disorders • Depression • Migraine • Mood Disorders • Pain • Psychiatry

Longitudinal effects of CGRP pathway-targeting migraine therapies on blood pressure and body mass index: A 12-month retrospective analysis (AHS 2025) - " Using data from electronic health records at Jefferson Headache Center, we conducted a retrospective study of adult patients with naïve use of either gepants (atogepant, rimegepant) or CGRP mAbs (erenumab, fremanezumab, galcanezumab) for migraine prevention. These findings suggest that most CGRP pathway-targeting migraine medications have negligible effects on monthly changes in BP over one year. These BP differences were small in magnitude and of unclear clinical significance. Study limitations include the unbalanced distribution of medications and potential changes in antihypertensive medication regimens during the one-year study period that could not be fully captured in our model."

Retrospective data • CNS Disorders • Migraine • Pain

Long-term persistence of patients with chronic migraine switching to onabotulinumtoxinA or a different calcitonin gene-related peptide monoclonal antibody (CGRP mAb) after initial CGRP mAb treatment (AHS 2025) - "This study included patients who had ≥1 claims of a CGRP mAb, then initiated another CGRP mAb (erenumab, fremanezumab, galacanezumab, eptinezumab) or onabotA for 12-24 months post-index. This retrospective, real-world study demonstrated that patients with CM who switched to onabotA treatment after an initial CGRP mAb were more likely to remain persistent on therapy for 12-24 months compared to patients with CM who switched to another CGRP mAb."

Clinical • CNS Disorders • Migraine • Pain

Real-world switch rates of injectable migraine preventive therapies in patients with chronic migraine (AHS 2025) - "The primary endpoint was treatment switching, defined by the occurrence of ≥1 claim for a different branded migraine preventive treatment (onabotA, CGRP mAb, or atogepant) in the 12 months following the index date... A total of 1869 patients met the study inclusion criteria, of which 723 initiated onabotA and 1146 initiated a CGRP mAb (303 erenumab, 308 fremanezumab, 517 galcanezumab, 18 eptinezumab) as their index therapy... Chronic migraine patients on a CGRP mAb were significantly more likely to switch to a different branded migraine preventive treatment within 12 months of treatment initiation compared to those on onabotA."

Clinical • Real-world • Real-world evidence • CNS Disorders • Migraine • Pain

Effects of injectable calcitonin gene-related peptide-antagonists on migraine-associated cost burden (AHS 2025) - "To date, three subcutaneous injections have been approved: erenumab-aooe, fremanezumab-vfrm, and galcanezumab-gnlm. While limited by a small sample size, the results support continued prescribing of injectable CGRP antagonists to increase cost savings at this VA medical center. These medications were associated with significant reductions in as-needed visits, abortive medication refills, and patient-reported migraine days. These results highlight the clinical, economic, and humanistic benefits of prescribing injectable CGRP antagonists to patients for migraine prevention."

CNS Disorders • Migraine • Pain

An interdisciplinary approach to medication overuse headache: A case study (AHS 2025) - "She had tried and failed Botulinum toxin injections, occipital nerve blocks and trigger point injections, sphenopalatine ganglion blocks, Amitriptyline, Propranolol, Venlafaxine, Emgality, Aimovig, Vyepti, Qulipta, and Cefaly. The interdisciplinary model with headache neurology, occupational therapy, pain psychology, and physical therapy allowed for continued reinforcement and collaborative integration to allow for a more in-depth assessment of the barriers contributing to medication overuse headache and the implementation of a successful, sustainable plan. The patient was successfully able to stop Excedrin and reduce Sumatriptan use significantly, implement self-regulation and cognitive strategies for pain and anxiety management, and reduce her monthly headache and migraine days by more than 75%. Emotion wheel"

Case study • Clinical • CNS Disorders • Cognitive Disorders • Depression • Migraine • Mood Disorders • Musculoskeletal Pain • Neuralgia • Pain • Psychiatry

Characteristics and eptinezumab infusion experience in participants in whom ≥1 prior preventive anti-CGRP treatment had failed: Interim results of an ongoing real-world study (AHS 2025) - "INFUSE includes adults ≥18 years of age with a diagnosis of migraine in whom ≥1 preventive a-CGRP treatment had failed (erenumab, fremanezumab, galcanezumab, atogepant, or rimegepant [prescribed every other day]). Results of this interim analysis of the INFUSE study indicate that individuals with migraine initiating eptinezumab treatment after ≥1 prior a-CGRP preventive treatment had failed typically have a long history of disease, severe migraine, and have cycled through three or more a-CGRP preventive treatments. The level of concern about initiating an IV treatment was low, and participants generally had a positive infusion experience."

Clinical • Real-world • Real-world evidence • CNS Disorders • Migraine • Pain • Psychiatry

Complete Resolution of New Daily Persistent Headache With Migraine-Like Features Following Erenumab Treatment: A Case Report. (PubMed, Cureus) - "This case highlights the diagnostic overlap between NDPH and chronic migraine presenting with continuous daily headache and suggests the potential benefit of calcitonin gene-related peptide-targeted therapy in patients with migraine-like NDPH phenotypes. Careful phenotypic characterization may improve therapeutic decision-making and support a syndromic approach to managing continuous daily headache disorders."

Journal • CNS Disorders • Migraine • Pain

Retrospective cohort study of anti-CGRP monoclonal antibody unresponsive migraine individuals treated with atogepant: The RESCUE study. (PubMed, Cephalalgia) - "Prior use of anti-CGRP mAbs included erenumab in 11.4% of participants, galcanezumab in 52.3% and fremanezumab in 86.3%. Five (11.4%) participants discontinued treatment due to side effects.ConclusionsAfter three months of treatment, atogepant led to a clinically meaningful improvement in a subset of participants. It may be a valuable preventive option for individuals unresponsive to anti-CGRP mAbs and warrants further investigation in prospective studies."

Journal • Retrospective data • CNS Disorders • Constipation • Gastroenterology • Gastrointestinal Disorder • Migraine • Pain

Treatment of Persistent Headache After Normalization of CSF Pressure. (PubMed, Continuum (Minneap Minn)) - "Erenumab, a monoclonal antibody to the calcitonin gene-related peptide receptor, was shown to reduce headache frequency in the first-ever prospective study of headache treatment in patients with idiopathic intracranial hypertension in ocular remission...Headache is the most common symptom to herald an intracranial pressure disturbance and may not resolve despite normalization of pressure. Neurologists must be aware that persistent headache does not automatically imply abnormal intracranial pressure in patients with previous disorders of CSF dynamics and informed of the possible alternative headache etiologies in these populations."

Journal • Review • Cardiovascular • CNS Disorders • Hypertension • Hypotension • Pain

Management of local and delayed cutaneous hypersensitivity reactions to anti-CGRP antibodies: implications for continuing treatment. (PubMed, Neurol Sci) - "This protocol offers a practical and effective approach to managing local skin reactions, promoting the continued use of anti-CGRP mAbs for migraine. Its simplicity facilitates implementation even in home-based care settings."

Journal • CNS Disorders • Dermatology • Immunology • Migraine • Pain • Pruritus

Repurposed versus disease-specific medicinals for the prophylaxis of migraine: an updated systematic review. (PubMed, Pain Manag) - "A comprehensive search of PubMed/MEDLINE and ClinicalTrials.gov was conducted to identify phase-3, placebo-controlled trials of gepants (atogepant, rimegepant), anti-CGRP mAbs (eptinezumab, erenumab, fremanezumab, galcanezumab), and traditional treatments (propranolol, topiramate, onabotulinumtoxinA). Anti-CGRP/R medications present a more favorable benefit/risk ratio than traditional treatments. These findings, combined with individual patient histories and preferences, can inform clinical decision-making."

Journal • Review • CNS Disorders • Migraine • Pain

Postmarketing safety of migraine prophylactic monoclonal antibodies: An EudraVigilance database analysis of eptinezumab, fremanezumab, galcanezumab, and erenumab. (PubMed, Headache) - "Almost all of the most reported and statistically significant adverse events were nonserious and consistent with the existing literature. Given the chronic nature of migraine treatment, continuous pharmacovigilance monitoring is essential to ensure their constant safe use in clinical practice."

Journal • P4 data • CNS Disorders • Dermatology • Fatigue • Migraine • Pain

Cost-Utility Analysis of Migraine Prevention Treatments for Chronic Migraine Headaches Patients in the United States (ISPOR 2025) - "OBJECTIVES: To evaluate the cost-effectiveness of migraine prevention treatments in patients with chronic migraine A hybrid decision-Markov model was constructed to evaluate the cost-effectiveness of prevention medications (eptinezumab, erenumab, and onabotulinumtoxinA) for chronic migraine. Eptinezumab was a cost-effective strategy at a WTP of $50,000 per QALY gained compared to onabotulinumtoxinA. However, onabotulinumtoxinA may be an alternative cost-effective option if eptinezumab was not tolerated by the patient."

Clinical • HEOR • CNS Disorders • Migraine • Pain