Title : Efficacy and safety of erenumab in preventive and therapeutic treatment of patients suffering from migraine: A meta analysis
Abstract:
Background: Erenumab, (AMG 334) is a first fully human monoclonal antibody that targets and blocks the canonical Calcitonin Gene related peptide (CGRP) receptor approved for use in migraine. CGRP plays a very pivotal role in patho-physiology of migraine. The objective was to generate statistical evidence on the basis of existing data for erenumab in terms of efficacy and safety in various treatment regimens with different dosages.
Methods: A total of 7 RCTs following PRISMA guidelines and matching inclusion and exclusion criteria were collected of erenumab vs placebo in treatment of migraine. Studies with >50% responder rate from baseline in terms of migraine days per month at 12 weeks was chosen as primary clinical outcome measure. Secondary outcomes chosen were mean migraine days from baseline and safety outcomes in terms of adverse events. 5.3 software was used for the calculation of Relative Risk(RR). P value less than 0.05 was considered significant.
Results: Data of 3615 patients were included. The use of Erenumab was associated with increased rates of achieving >50% responder rate as compared with placebo. (RR= 1.591; 95% CI =1.322 to 1.915; P <0.001). Both 70mg and 140 mg of erenumab were associated with increase in responder rate. Reduction in mean migraine days was observed in erenumab as compared to placebo, (SMD= 7.348; 95% CI= 4.733 to 9.963; P <0.001). Treatment related adverse events (RR = 0.974; 95% CI = 0.901 to 1.052; P= 0.496) were not significant in erenumab as compared to placebo.
Conclusion: Erenumab subcutaneous once monthly was the most efficacious treatment regimen and was not associated with a significant risk for treatment related adverse events.
Keywords: Erenumab, efficacy, safety, migraine, meta-analysis.
