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

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

Short-Term Immunosuppression in Rats Induces Prolonged Immune Tolerance Towards a Human Monoclonal Antibody, Erenumab. (PubMed, AAPS J) - "In two studies, we investigated dosing regimens using the immunosuppressants methotrexate and tacrolimus/sirolimus combination, and compared them to non-immunosuppressed control groups. Correspondingly, erenumab systemic exposures were maintained throughout the study period in all animals in the tacrolimus/sirolimus group and were similar to the erenumab exposures in ADA-negative animals of the control group. In contrast, ADA-positive animals in the control group exhibited a 60-80% reduction in erenumab exposures."

Journal • Preclinical

DRAGON: Study of Efficacy and Safety of Erenumab in Adult Chronic Migraine Patients (clinicaltrials.gov) - P3 | N=557 | Completed | Sponsor: Novartis Pharmaceuticals | Active, not recruiting ➔ Completed

Trial completion • CNS Disorders • Migraine • Pain

Results of our hospital's erenumab treatment (JSNE 2025) - No abstract available

Clinical • CNS Disorders • Migraine • Pain

Efficacy of monoclonal antibodies against CGRP in migraine patients with fibromyalgia comorbidity: a retrospective monocentric observational study. (PubMed, J Headache Pain) - "We found that in migraine suffereres with FM, anti-CGRP monoclonal antibodies had a similar beneficial effect on migraine as in non-fibromyalgia patients, in addition to reducing somatic pain and global disability from the disease. The anti-CGRP agents, represent a good option for the treatment of migraineurs with fibromyalgia, for which no resolutive therapy is yet available."

Journal • Observational data • Retrospective data • CNS Disorders • Fibromyalgia • Migraine • Musculoskeletal Pain • Pain • Rheumatology

Safety, efficacy, and compliance of moderate-to-high dose eptinezumab and erenumab in chronic migraine patients with medication-overuse headache: an updated systematic review and meta-analysis. (PubMed, J Headache Pain) - "Standard-to-high dose anti-CGRP therapies (eptinezumab, erenumab) effectively reduce monthly migraine days and improve MOH remission rates with minimal adverse effects, showing good tolerability in CM patients with MOH."

Compliance • Journal • Retrospective data • CNS Disorders • Infectious Disease • Migraine • Pain • Respiratory Diseases

Increased infection risk in patients on preventive CGRP-targeting therapies- a meta-analysis and clinical effect assessment. (PubMed, J Headache Pain) - "CGRP has multiple and often potentially opposing effects on the immune system. In effect, preventive CGRP pathway antagonists (especially eptinezumab and galcanezumab) possibly only mildly increase the risk of infections. However, it is unlikely to affect most migraine patients considering relatively high NNH, low effect size and few infectious SAEs reported so far. The result of CGRP-targeting therapies potentially depends on the type of pathogen and patient's immune status. Consequently, in immunocompromised patients or at public health levels the increased infection risk may have more pronounced effect."

Clinical • Journal • Retrospective data • Review • CNS Disorders • Infectious Disease • Migraine • Pain

Swiss Quality of Life and Health Care Impact Assessment in a Real-World Erenumab-Treated Migraine Population: Results over 2 years. (PubMed, Headache) - "Overall, erenumab treatment significantly reduced the burden of migraine, leading to improved quality of life for patients and their families over a treatment period of 2 years."

HEOR • Journal • Real-world evidence • CNS Disorders • Migraine • Pain

Clinical predictors for efficacy of erenumab for migraine: a Registry for Migraine (REFORM) study. (PubMed, Brain Commun) - "Moreover, patients with a more severe clinical phenotype were more likely to respond later. Prediction of treatment responses might be improved by incorporating machine learning models and multimodal biomarkers, facilitating a shift towards personalized medicine."

Journal • CNS Disorders • Migraine • Pain

Plasma SuPAR and therapeutic response to erenumab in migraine: a REFORM study. (PubMed, J Headache Pain) - P4 | "We did not find an association between baseline plasma suPAR levels and response to erenumab. Plasma suPAR concentrations remained stable, even among participants with aura. These findings suggest that systemic low-grade inflammation, as measured by suPAR, does not influence treatment efficacy."

Biomarker • Journal • CNS Disorders • Inflammation • Migraine • Pain

Migraine treatment with CGRP monoclonal antibodies: patient evaluation of a mandatory treatment holiday in Belgium. (PubMed, Acta Neurol Belg) - "A rigid, mandatory treatment holiday of two to three months poses significant challenges for a substantial subset of patients, leading to rapid migraine deterioration and increased anxiety. The observed association between migraine deterioration and anxiety highlights the need for patient education strategies. Policy makers should consider these findings to develop more flexible, patient-centered treatment approaches that optimize outcomes."

Journal • CNS Disorders • Migraine • Mood Disorders • Pain • Psychiatry

The Optimum Dose of Erenumab to Improve Quality of Life in Patients with Episodic Migraines: A Systematic Review, Meta-analysis and Network Meta-analysis. (P10-12.005). (PubMed, Neurology) - "Dr. Alavinia has nothing to disclose."

Clinical • HEOR • Journal • Retrospective data • Review • CNS Disorders • Migraine • Pain

Successful Management of Wearing-off effect with Eptinezumab: Lessons from a case with Chronic Migraine Refractory to Two Subcutaneous CGRP Antibodies (PubMed, Rev Neurol) - "She failed to respond to multiple oral preventatives, botulinum toxin, and two CGRP antibodies (erenumab and galcanezumab). Conclusions CGRP antibodies can show a wearing-off effect, which should be identified in order to plan individualized treatment and avoid an incorrect interpretation as therapeutic failure. Our case also shows that patients with chronic migraine refractory to two antibodies can respond to a third CGRP antibody, in this case, intravenous eptinezumab."

Journal • CNS Disorders • Migraine • Pain

A National Cross-Sectional Survey on Real-World Experiences of Calcitonin Gene-Related Peptide (CGRP) Monoclonal Antibody Use in Adults with Migraine in Finland. (PubMed, Pain Ther) - "Patient experiences of using subcutaneous CGRP mAbs in Finland showed improvements in several migraine-related factors, supporting the potential for CGRP mAbs to improve the quality of life of adults with migraine."

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

Multidisciplinary Translational Approach to Investigate Mechanisms Predictors & Prevention of Persistent PTH (clinicaltrials.gov) - P2 | N=112 | Active, not recruiting | Sponsor: Mayo Clinic | Recruiting ➔ Active, not recruiting

Enrollment closed • Pain

Quickest way to less headache days: an operational research model and its implementation for chronic migraine. (PubMed, BMC Neurol) - "We propose an optimal sequence for preventive medication trial for patients with chronic migraine. Since our model makes limited assumptions on the characteristics of disease, it can be readily applied also to episodic migraine, given the appropriate data as input. Indeed, our model can be applied to other scenarios so long as probability of success/adverse event as a function of time can be estimated. As such, we believe our model may have implications beyond our sub-specialty."

Journal • CNS Disorders • Migraine • Pain

Health care resource utilization and direct costs incurred over 12 months by patients with migraine initiating self-injectable calcitonin gene-related peptide monoclonal antibodies: A US real-world study. (PubMed, J Manag Care Spec Pharm) - "HCRU and direct cost differences observed at 12 months following initiation of self-injectable CGRP mAbs for migraine prevention were numerically similar across cohorts for patients treated with galcanezumab, fremanezumab, and erenumab. More work should be done to learn if these drugs perform differently with respect to other important factors not examined here."

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

Unveiling the efficacy and safety of Erenumab, a monoclonal antibody targeting calcitonin gene-related peptide (CGRP) receptor, in patients with chronic and episodic migraine: a GRADE-assessed systematic review and meta-analysis of randomized clinical trials with subgroup analysis. (PubMed, Head Face Med) - "This meta-analysis found that Erenumab significantly reduced migraine attack frequency, medication days, and physical impairment. It was more effective for patients with prior treatment failures. The 140 mg dose showed better MSMD reduction than 70 mg. Erenumab's safety profile was similar to that of placebo, with only constipation noted as significant."

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

Efficacy and safety of mAbs anti-CGRP/CGRP R (eptinezumab and erenumab) or atogepant in combination with onabotulinumtoxinA in refractory chronic migraine: a clinical trial protocol. (PubMed, Pain Manag) - "Chronic migraine is a disabling neurovascular disorder that represents the leading cause of years lived with disability in people under 50 with a remarkable social burden due to widespread resistance to the front-line treatments used routinely in current clinical practice. Furthermore, a feasible salivary biomarker of migraine is under investigation in the prospective stage of the study. Based on recent expert opinions supporting the switch to easy-to-use small molecule calcitonin gene-related peptide (CGRP)-targeting, i.e. rimegepant or atogepant in unresponsive patients, the present study may offer to clinicians a novel treatment to enhance the therapeutic preventive machinery in chronic migraine."

Journal • CNS Disorders • Migraine • Pain

Patient satisfaction with calcitonin gene-related peptide monoclonal antibodies in migraine: A multicenter prospective cohort study. (PubMed, Headache) - "Most patients were satisfied with CGRP mAbs' effectiveness, tolerability, and convenience in a real-world setting. Interestingly, increasing TS was associated with meaningful reductions in frequency, impact, and disability caused by migraine."

Journal • CNS Disorders • Migraine • Pain

CROATIAN GUIDELINES FOR SPECIFIC PREVENTIVE TREATMENT OF MIGRAINE WITH MONOCLONAL ANTIBODIES TARGETING CALCITONIN GENE-RELATED PEPTIDE (CGRP) (EPTINEZUMAB, FREMANEZUMAB, AND GALCANEZUMAB) OR THE CGRP RECEPTOR (ERENUMAB). (PubMed, Acta Clin Croat) - "These medications may be considered as first-line prophylactic therapy depending on the patient's history, concomitant diseases, and disease burden. Further real-world studies are needed to elucidate other aspects of their application."

Clinical guideline • Journal • Review • CNS Disorders • Inflammation • Migraine • Pain