Edited by Susan Sadoughi, MD
Two humanized monoclonal antibodies seem effective in preventing migraine, according to two industry-conducted, phase III trials in the New England Journal of Medicine. The investigational treatments target the calcitonin gene-related peptide (CGRP) or its receptor; CGRP affects neuronal modulation of pain and vascular activity.
In the first trial, researchers randomized nearly 1000 adults with episodic migraine (mean of 8 migraine days a month) to receive monthly subcutaneous injections of erenumab (70 or 140 mg) or placebo. From months 4 to 6, erenumab recipients had a greater reduction in monthly migraine days than did placebo recipients (mean reduction of 3.2–3.7 vs. 1.8 days).
In the second trial, over 1000 patients with chronic migraine (mean, 13 headache days per month) were randomized to receive injections of fremanezumab (quarterly or monthly) or placebo. At 12 weeks, fremanezumab recipients had a greater reduction in headache days per month (reduction of 4.3–4.6 vs. 2.5 days with placebo). Fremanezumab also reduced migraine days.
An editorialist concludes: “These drugs may find a specific role in the treatment of patients who have migraines that are refractory to treatment or who are severely disabled by headaches.”