Clinical predictors for efficacy of erenumab for migraine: a Registry for Migraine (REFORM) study
Abstract
Abstract Erenumab has proven effective for migraine prevention; however, a substantial proportion of people with migraine do not benefit from treatment, and among those who do, there is considerable variability in response. This study aimed to identify clinical predictors of therapeutic response to erenumab and evaluate their predictive value in a large cohort of people with migraine. We conducted a single-centre, prospective, longitudinal cohort study of adults with migraine, experiencing ≥4 monthly migraine days. All participants received erenumab 140 mg monthly for 24 weeks and recorded their response in a headache diary with daily entries. A semi-structured interview was conducted at enrolment, and patient-reported outcome measures were collected before and after treatment. Treatment responders were classified as participants achieving a reduction from baseline of ≥50% in average monthly migraine days across weeks 13 through 24. Clinical predictors were analysed using logistic regression analysis. In total, 570 participants with migraine provided data eligible for analysis. Of these, 298 (52.3%) participants were classified as treatment responders, and the remaining 272 (47.7%) were non-responders. Independent predictors associated with a lower likelihood of response to erenumab were chronic migraine (odds ratio 0.63, 95% confidence interval 0.43–0.91; P = 0.030), daily headache (odds ratio 0.41, 95% confidence interval 0.24–0.67; P = 0.003) and previous failure of ≥3…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 570 participants or records.
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