Efficacy and safety of erenumab in the preventive treatment of migraine in adults: a systematic review

Abstract

Objective To systematically evaluate the clinical efficacy and safety of erenumab in the preventive treatment of migraine in adults.  Methods Taking Erenumab or AMG334 AND Migraine as search terms, retrieve in databases such as PubMed, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wanfang Data and VIP, and search engines such as Google Scholar, in order to collect randomized controlled trials (RCTs) of erenumab in the preventive treatment of adult migraine from January 1, 2001 to August 1, 2018. Jadad Scale was used to evaluate the quality of literatures.  Results A total of 68 English articles were enrolled after preliminary searching, and 4 high-quality RCTs (Jadad score ≥ 4) with a total of 2682 cases (1626 cases in erenumab group and 1056 cases in placebo group) were finally included after excluding duplicates and those not meeting the inclusion criteria. The results were as follows: 1) compared with placebo, erenumab (70 mg/4 weeks or per month, 140 mg/4 weeks) was more effective (effective defined as ≥ 50% reduction from baseline migraine days per month) and showed significantly higher efficacy in reducing migraine days per month, the use of migraine-specific medication, Migraine Physical Function Impact Diary on Everyday Activities and Physical Impairment (MPFID -EA and MPFID-PI) in treating migraine patients. 2) The incidence of adverse reactions was low and mild, and there was no significant difference compared with placebo. Common adverse reactions included injection site pain, upper respiratory tract infection, nasopharyngitis, etc. There were very few patients who discontinued treatment due to adverse drug reactions.  Conclusions Erenumab is safe and effective in the preventive treatment of migraine in adults.

DOI: 10.3969/j.issn.1672-6731.2018.09.004