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This real-life study aimed to examine the rate and potential predictors of change from chronic migraine (CM) to episodic migraine (EM).
In clinical practice, many patients on erenumab treatment
have chronic migraine (CM). As per this real-life data from an Italian region,
the percentage of patients changing to EM was approximately half at 1st month
and soared up to 3 quarters at 5th month. The high rate of conversion to EM in
these difficult-to-treat patients with a prior CM and many earlier preventive
treatment disappointments supports erenumab’s effectiveness for preventive
treatment of CM patients.
This real-life study aimed to examine the rate
and potential predictors of change from chronic migraine (CM) to episodic
migraine (EM).
A subgroup analysis was performed in patients
treated with erenumab in central Italy. Treatment was provided as per existing
clinical practice. The patients satisfying the definition of CM for 3 months
prior to erenumab usage and with approximately 6 months of follow-up after the
erenumab use were included. The rate of change to EM from starting to months 4
to 6 of treatment and through each month of treatment was investigated. The
reduction in monthly headache days (MHDs), acute medicine days, and average
headache intensity on a Numerical Rating Scale (NRS) to examine the clinical
validity of conversion to EM was noted.
Ninety-one patients with CM were included. At Months 4–6, 62 patients (68.1%) changed from CM to EM; the percentage of converters augmented from Month 1 till Month 5 in the following figure:
Figure:
Rates of conversion to
episodic migraine at Months 4–6 and following each month of treatment as per
headache days per month
On the whole, median
MHDs reduced from 26.5 to 7.5 than with baseline, whereas median acute
medication days reduced from 21 to 6 and median NRS scores reduced from 8 to 6.
There were substantial decreases observed both in converters and in
non-converters. No noteworthy indicators of conversion to EM among the
patients’ baseline features were found.
About two-thirds of patients with CM changed
to EM in 6 months of erenumab treatment. The acute medicine usage, MHDs and
headache intensity reduced irrespective of change from CM to EM.
The Journal of Headache and Pain
Conversion from chronic to episodic migraine in patients treated with erenumab: real-life data from an Italian region
Raffaele Ornello et al.
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