Authors: Guy P Boudreau.
Objectives: Chronic migraineurs having failed more than 3 preventive drugs were treated with Erenumab alone or as an add on therapy, we assessed the frequency of monthly migraine days, the value of an add on therapy, and all adverse events.
Method: After signing an informed consent, patients were clustered in 3 categories. Group I: Erenumab alone. (No botox cohort). Group II: Botulinum Toxin A (Botox), with Erenumab. (Botox cohort). Group III: oral preventive drug with Erenumab. (No Botox cohort).
Results: Evaluation was after the 4 th injection session. A total of 158 patients were involved. 90 (13%) patients in the Botox cohort. 83 (15%) patients in the no Botox cohort. 53pts/158 (34%) obtained no improvement, 36pts/158 (23%) obtained a reduction of the intensity only, 69pts/158 (43%) reduced the frequency of their monthly migraine days. 57% of patients failed the primary end point. 69 patients reduced their migraine frequency: in group I: 16patients (26%), In group II, 45 patients (65%), and group III, 11 patients (15%) reduced their monthly migraine days by 5-7 days. 72 adverse events were experienced mostly with the 140 mg dose. The most frequent were: constipation 34%, fatigue 19%, itching 7.5%, muscle cramps 6.3%, increased headache 4.4%, rhinitis 4.4%, injection site discomfort 3.7%, lack of energy 3.1%.
Conclusion: The add on of Erenumab to a preventive therapy is more effective than Erenumab alone, Botulinum toxin A with Erenumab was the most effective combination.