Clinical Edge Journal Scan

Migraine: Erenumab demonstrates superior efficacy over topiramate


Key clinical point: Erenumab demonstrated an early onset of and superior efficacy in achieving 50% reduction in monthly migraine days (MMD) than topiramate in patients with migraine.

Major finding: A significantly higher proportion of patients receiving erenumab vs topiramate reported 50% reduction in MMD at 1 month (39.2% vs 24.0%) and during the last 3 months (60.3% vs 43.3%) of treatment (both P < .001). Reductions in MMD over last 3 months were significantly higher with erenumab vs topiramate (mean difference 1.24 days; P < .001).

Study details: This post hoc analysis of the phase 4 HER-MES trial included 776 patients with migraine who were naive to migraine prophylactics or had failed or were ill-suited for metoprolol/propranolol, amitriptyline, or flunarizine and were randomized to receive erenumab (70 or 140 mg/month) or topiramate (50-100 mg/day).

Disclosures: This study was funded by Novartis Pharma GmbH, Germany. Four authors, including the first author, declared being employees of and holding stocks in Novartis . U Reuter reported receiving grants, personal fees, and other supports from Novartis and various other sources.

Source: Ehrlich M et al. Erenumab versus topiramate: Post hoc efficacy analysis from the HER MES study. J Headache Pain. 2022;23:141 (Nov 15). Doi: 10.1186/s10194-022-01511-y

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