New Therapy Aimovig (erenumab) in Development to Prevent Tough-to-Treat Migraines
TUESDAY, April 17, 2018 -- The millions of Americans who suffer from migraine may have a new source of hope -- the first of a new class of drugs that harness the immune system to ward off the headaches.
Researchers found that the injected drug, called erenumab, could prevent migraines if other treatments fail to do so.
Erenumab (brand name Aimovig) works by blocking a key brain "neurotransmitter" chemical that sends out pain signals, the research team explained.
Working with a group of people with tough-to-treat migraine, the "study found that erenumab reduced the average number of monthly migraine headaches by more than 50 percent for nearly a third of study participants," lead researcher Dr. Uwe Reuter, of The Charite University Medicine Berlin in Germany, said in a news release from the American Academy of Neurology (AAN).
The drug is currently up for approval by the U.S. Food and Drug Administration. One U.S. migraine specialist was enthused by the findings.
"We have a new class of drugs -- erenumab likely to be the first to be on the market -- that are showing great promise in preventing migraine attacks," said Dr. Randall Berliner. He's an adjunct neurologist at Lenox Hill Hospital in New York City and wasn't involved in the new trial.
As Berliner explained, it's been a long, tough road to find medicines that provide reliable relief to migraine sufferers.
Twenty years ago, a group of drugs called triptans were introduced, and have since become the standard of care, he said. But they don't work for everyone.
Erenumab, and meds like it, target "calcitonin gene-related peptide" (CGRP). Erenumab acts like an immune-system antibody to stop this neurotransmitting chemical from binding to a nerve and sending out migraine pain signals.
"Our bodies typically produce antibodies to fight off infections, cancers and other foreign agents that the immune system deems harmful. But physicians and scientists have learned to develop antibodies that can target agents that cause disease: tumors, abnormal immune cells, and now CGRP," Berliner explained.
"In so doing, erenumab very safely blocks a good deal of the migraines from occurring in the first place," Berliner said.
The new study was funded by drug maker Novartis. In their research, Reuter's team tested erenumab on 246 people with the treatment-resistant migraine.
Of these participants, 39 percent had already failed to respond to two available migraine medications, 38 percent were treated with three other medications and 23 percent had tried four different medications to help control their migraines.
On average, these migraine sufferers experienced nine migraine headaches each month and took an acute migraine drug to stop an attack five times each month.
During the study, each person received injections of either 140 milligrams of erenumab or a "dummy" placebo once per month for three months.
After three months, those treated with erenumab were almost three times as likely to have fewer days with migraine pain, compared to people who'd only gotten the placebo. Days with migraine headaches were reduced by at least 50 percent compared to those who were given the placebo. In addition to fewer days with headaches, these patients also took acute migraine drugs less often.
Of all the participants, 30 percent treated with erenumab said their migraine frequency drop by half. The same was true for only 14 percent in the placebo group. The drug was also not associated with significant side effects.
All of this "can greatly improve a person's quality of life," Reuter said. "Our results show that people who thought their migraines were difficult to prevent may actually have hope of finding pain relief."
What's the next step? According to Reuter, "more research is now needed to understand who is most likely to benefit from this new treatment."
The researchers added that larger studies are also needed to evaluate the long-term safety and effectiveness of the medication.
Dr. Noah Rosen directs the Headache Center at Northwell Health's Neuroscience Institute in Great Neck, N.Y. He agreed that "too many people have suffered because a lack of good migraine-specific prevention and from the side effects of many of the currently available options. If we are able to figure out which migraine sufferers are most likely to benefit from this treatment, it will also let us provide care more effectively."
The study findings haven't been published yet, but are expected to be presented next Tuesday at the AAN's annual meeting in Los Angeles. Experts note that findings presented at medical meetings are typically considered preliminary until published in a peer-reviewed journal.
The American Academy of Family Physicians has more on migraine.
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Posted: April 2018