Efficacy and tolerability of erenumab for chronic migraine in association with medication overuse: A systematic review and meta-analysis
Abstract
Methods: We conducted a systematic review and meta-analysis following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, retrieving data from PubMed, Elsevier, Web of Science, and Cochrane Central Register of Controlled Trials . Primary outcomes included changes from baseline in acute headache medication days and monthly migraine days (MMD). Secondary outcomes comprised the incidence of adverse events (AEs), common AEs, and the proportion of patients achieving a ≥ 50% reduction in MMDs.
Results: Five randomized controlled trials including 875 patients (mean age of 42.7 years) were analyzed. Erenumab treatment was associated with significant reductions in acute headache medication days (mean difference = -1.72; 95% confidence interval [CI]: -2.81 to -0.62; p = 0.002) and MMDs (mean difference = -1.88; 95% CI: -2.68 to -1.07; p 2 = 14%), the overall incidence of AEs was not significantly different compared to placebo (RR = 1.02; 95% CI: 0.92 to 1.14; I2 = 57%). A higher proportion of patients achieved a ≥50% reduction in MMDs after 3 months in the erenumab group (RR = 1.49; 95% CI: 1.26 to 1.77; I2 = 22%).
Conclusion: Erenumab appears effective in reducing migraine frequency and symptomatic medication use among patients with chronic migraine MOH, with an acceptable tolerability profile.
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 875 participants or records.
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