The use of erenumab for preventing migraine

Abstract

Background: In 2018, calcitonin gene-related peptides (CGRP) were approved in the United States as the first class of specific migraine prevention drugs. Objectives: To analyze the efficacy and therapeutic safety of erenumab for preventing migraine. Methods: A narrative literature review was carried out by researching in the PubMed/MEDLINE and SciELO databases, using the descriptor “migraine disorders” and the keyword “erenumab” combined by the Boolean operator AND. Eight articles were selected, between 2017 and 2020. Results: The pathophysiology of migraine is related to CGRP through nociceptive modulation in the trigeminovascular system. Therefore, erenumab was developed, which is a human monoclonal antibody that binds selectively and potently to the canonical receptor of CGRP and acts as an antagonist of CGRP. Evidence indicates that the monthly dose of 70mg or 140mg reduces the frequency, quality and intensity of acute and chronic migraines. Studies report a decrease of two to six days of migraine using erenumab. The same adverse reactions occurred in both placebo and experimental groups, including upper respiratory tract viral infection, pain at the injection site and nausea. Conclusions: Erenumab is a promising drug, because it showed efficacy in the first days of treatment, absence of significant side effects and low rate of discontinuation. Aspects such as safety, effect durability, impact on quality of life and cost require further research.