A retrospective evaluation of the combination of erenumab and onabotulinum toxin A for the prevention of chronic migraine
Abstract
OBJECTIVE
Prior to the approval of erenumab, onabotulinum toxin A (onabot A) was the only Food and Drug Administration-approved chronic migraine preventive treatment. In this study, we assess the safety and efficacy of the combination of erenumab and onabot A for chronic migraine prevention.
METHODS
This is a retrospective cohort study of patients with a diagnosis of chronic migraine receiving onabot A, who were additionally started on erenumab. Primary endpoint was a decrease in number of migraine days while on the combination treatment as compared to onabot A alone. Secondary endpoints included a decrease in headache days and reported side effects.
RESULTS
When erenumab was added to onabot A, participants (n = 50) experienced significantly lower number of monthly migraine days (11.3 ± 9.3 vs. 14.9 ± 9.4, p < 0.001). The treatment of onabot A and erenumab also significantly lowered the number of monthly headache days (18.2 ± 10.3 vs. 20.7 ± 9.1, p = 0.042). There were no "severe" adverse effects reported in the combined treatment group.
CONCLUSION
This retrospective case series showed a reduction in monthly migraine and headache days with the treatment combination of erenumab and onabot A compared to onabot A alone in patients with chronic migraine.
How strong is the evidence?
Evidence Hub reads this as a case series, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health. Reported size: 50 participants or records.
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