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Erenumab Helps Convert Migraines From Chronic to Episodic

Medically Reviewed by Jabeen Begum, MD on November 08, 2021

New research shows that erenumab, sold under the brand name Aimovig, helps people with chronic migraines convert to an episodic pattern shortly after starting the medicine. In this trial, 71% of people with chronic migraines who were treated for one year converted to episodic migraines. Erenumab was also associated with improvement in the headaches that did occur. The improvement was noticed after the first treatment and continued over the course of the trial. 

Erenumab is an anti-calcitonin gene-related peptide (CGRP) monoclonal antibody. This is the first preventative treatment developed specifically for the treatment of migraines. During a migraine, your nerves and blood vessels release CGRP, a protein in the brain that has a role in the transmission of pain. Erenumab works by blocking the action of CGRP, which prevents migraine from forming. 

Monoclonal antibodies are proteins that are all grown from the same genetic material. They can precisely target specific processes in your body. They are most well-known for their use in vaccines to help prevent or fight infections. These antibodies remain active and work in your body for weeks or months. In the case of erenumab, it's usually given as a monthly dose. 

Chronic migraines occur when you have 15 or more headaches monthly, with at least 8 of those being migraines, for at least three months. People who have chronic migraines often also have medication overuse headaches, which are caused by regular use of headache medicine such as ibuprofen. 

One study included 82 people who had chronic migraines and had tried and failed at least other types of preventative treatments. The people in the study took erenumab every 28 days for 13 months. They started at 70 mg monthly, and their healthcare provider could increase the dose to 140 mg every 28 days. By the end of the study, 36.2% of patients had a 75% or greater decrease in migraines, and 38.4% had a 50% to 74% decrease in migraines. The average amount of monthly doses of pain medicine people took for migraines decreased from 31.9 doses to 8.1 doses by the end of the study.

No patients stopped the treatment because of adverse reactions, although around 50% reported some adverse reactions. The most common adverse reactions were tiredness, constipation, or a skin reaction from the shot.

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SOURCES:

Medscape: "Erenumab Tied to Rapid Conversion From Chronic to Acute Migraine."

National Headache Foundation: "CGRP: What You Need to Know."

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