Erenumab Effective in Preventing Migraine, Study Shows

Erenumab Effective in Preventing Migraine, Study Shows

By Staff.

The company that makes erenumab – Amgen (NASDAQ: AMGN) – has a lot to say about its drug and its ability to manage migraine, it’s presenting 19 abstracts at the American Headache Society this weekend.

“Migraine is a disabling disease for many patients. It disrupts daily living and the ability to function and participate in activities with loved ones,” said Sean E. Harper, M.D., executive vice president of Research and Development at Amgen. “The data from our clinical program demonstrate that erenumab has a sustained effect in significantly reducing the number of days people suffer from migraine each month. Based on the benefit-risk profile seen in clinical studies, erenumab is poised to become the first migraine-specific preventive option blocking the calcitonin gene-related peptide, or CGRP, receptor that could help get many patients back to doing the things they love.”

The following comes from a company press release:

Excessive use of acute pain-relief medications is common among people who suffer from migraine as they desperately try to control the symptoms. Among the patients experiencing 15 or more headache days a month in the erenumab Phase 2 study (n=667), 41 percent met strict criteria for medication overuse. Compared to a 3.5-day reduction in placebo, both dosages of erenumab reduced mean monthly migraine days by 6.6 by the end of the study (both p<0.001 versus placebo). Furthermore, days requiring acute pain-relief medications were also significantly reduced in both dosage arms (2.1-day reduction for placebo, compared to 5.4 days for erenumab 70 mg and 4.9 for erenumab 140 mg; both p<0.001 versus placebo).

Detailed results from the positive six-month STRIVE study of erenumab 70 mg and 140 mg, and the positive three-month ARISE study of erenumab 70 mg will also be presented at the meeting. These data include both primary and secondary endpoints, evaluating the reduction in monthly migraine days and the percentage of patients who responded to erenumab. Results from STRIVE have been submitted for peer-reviewed publication.

The safety profile of erenumab was similar to placebo across all treatment arms in the Phase 2 and Phase 3 studies. The most common adverse events across the studies were upper respiratory tract infection, injection site pain, nausea and nasopharyngitis.

Erenumab is a human monoclonal antibody specifically designed for the prevention of migraine. Erenumab specifically inhibits the CGRP receptor, believed to play a critical role in mediating the incapacitating pain of migraine.  Across the four placebo-controlled Phase 2 and Phase 3 clinical studies, more than 2,600 patients have been exposed to erenumab.

These data support the first submissions in the United States (U.S.) and European Union for a CGRP pathway inhibitor in migraine prevention. In addition, an ongoing extension trial is underway evaluating people with migraine for up to five years.

Amgen and Novartis will co-commercialize erenumab in the U.S. Amgen has exclusive commercialization rights to the drug in Japan and Novartis has exclusive rights to commercialize in rest of world.

Amgen-sponsored abstracts at the 2017 Annual Scientific Meeting of the AHS include:

Clinical Studies

  • Early Onset of Efficacy in a Phase 2 Clinical Trial of Erenumab in Patients with Chronic Migraine

Poster #PS24, Saturday, June 10, 6:30 a.m. – 5 p.m. ET

  • A Multicenter, Open-label, Pharmacokinetic Drug Interaction Study of Erenumab (AMG 334) and a Combined Oral Contraceptive in Healthy Female Subjects (Ph1b DDI OC)

Poster #PS23, Saturday, June 10, 6:30 a.m. – 5 p.m. ET

  • Chronic Migraine Treatment with Erenumab: Responder Rates

Poster #PS33, Saturday, June 10, 6:30 a.m. – 5 p.m. ET

  • Efficacy of Erenumab for the Treatment of Patients with Chronic Migraine in Presence of Medication Overuse

Poster #PS32, Saturday, June 10, 6:30 a.m. – 5 p.m. ET

  • Phase 3, Randomized, Double-Blind, Placebo-Controlled Study to Evaluate the Efficacy and Safety of Erenumab (AMG 334) in Migraine Prevention: Primary Results of the STRIVE Trial

Platform Presentation #IOR04, Saturday, June 10, 8:30 – 8:40 a.m. ET

  • A Phase 3, Randomized, Double-Blind, Placebo-Controlled Study to Evaluate the Efficacy and Safety of Erenumab in Migraine Prevention: Primary Results of the ARISE Trial

Poster #PS21, Saturday, June 10, 6:30 a.m. – 5 p.m. ET

  • A Phase 2 Randomized, Double-Blind, Placebo-Controlled Study to Evaluate the Efficacy and Safety of Erenumab (AMG 334) in Chronic Migraine Prevention

Platform Presentation #IOR07, Saturday, June 10, 9 – 9:10 a.m. ET

  • Patient Reported Outcomes in Chronic Migraine Patients Receiving Placebo or Erenumab (AMG 334) in a Phase 2 Randomized, Double-Blind Study

Poster #PS34, Saturday, June 10, 6:30 a.m. – 5 p.m. ET

  • Patient-Reported Outcomes from the STRIVE Trial: A Phase 3, Randomized, Double-Blind Study of Erenumab in Subjects with Episodic Migraine

Poster #PS35 Saturday, June 10, 6:30 a.m. – 5 p.m. ET

  • Patient-Reported Outcomes from the ARISE Trial: A Phase 3, Randomized, Double-Blind Study of Erenumab in Subjects with Episodic Migraine

Poster #PS22, Saturday, June 10, 6:30 a.m. – 5 p.m. ET

Global Health Economics

  • The Impact of Physical Functioning in Adults with Chronic and Episodic Migraine

Poster #PF47, Friday, June 9, 6:30 a.m. – 5 p.m. ET

  • Patient Satisfaction with Current Prophylactic Migraine Medications

Poster #PF02, Friday, June 9, 6:30 a.m. – 5 p.m. ET

  • Risk of Cerebrovascular Events in Migraine Patients Treated with Prophylactic Medications

Poster #PF66, Friday, June 9, 6:30 a.m. – 5 p.m. ET

  • Development and Psychometric Validation of the Migraine Functional Impact Questionnaire (MFIQ): a New Instrument Measuring the Impact of Migraine on Physical, Social, and Emotional Functioning

Poster #PF40, Friday, June 9, 6:30 a.m. – 5 p.m. ET

  • How much change in headache-related disability is clinically meaningful? Estimating minimally important difference (MID) or change in MIDAS using data from the AMPP Study

Poster #PF52, Friday, June 9, 6:30 a.m. – 5 p.m. ET

  • Improving Communications Between People with Migraine and Healthcare Professionals for Optimized Migraine Management: A Modified Delphi Approach to Designing a Migraine Tracker App

Poster #PS61, Saturday, June 10, 6:30 a.m. – 5 p.m. ET

  • Healthcare Costs and Utilization and Medication Treatment Patterns Among Migraine Patients: A Retrospective Analysis

Poster #PS58, Saturday, June 10, 6:30 a.m. – 5 p.m. ET

Center for Observational Research

  • Risk of Cardiovascular Events in Migraine Patients Treated with Prophylactic Medications

Poster #PF03, Friday, June 9, 6:30 a.m. – 5 p.m. ET 

Late-Breaking Research

  • Effect of Anti-CGRP Receptor Antibody AA58 on CGRP Receptor Internalization and Trafficking

Late-Breaking Poster #PF85LB, Friday, June 9, 6:30 a.m. – 5 p.m. ET

About the 20120295 Study

The 20120295 study is a global Phase 2, randomized, 12-week, double-blind, placebo-controlled study evaluating the safety and efficacy of erenumab in chronic migraine prevention. In the study, 667 patients were randomized to receive once-monthly subcutaneous placebo or erenumab (70 mg or 140 mg) in a 3:2:2 ratio, respectively. The primary endpoint was change in monthly migraine days from baseline to the last four weeks of the 12-week treatment phase in patients with chronic migraine (the number of migraine days between weeks nine and 12). Secondary study endpoints included reduction of at least 50 percent from baseline in monthly migraine days, change from baseline in monthly acute migraine-specific medication days and change from baseline in cumulative monthly headache hours.

About Erenumab Phase 3 Studies

STRIVE (STudy to evaluate the efficacy and safety of erenumab in migRaIne preVEntion, 20120296) is a global Phase 3, multicenter, randomized six-month, double-blind, placebo-controlled study evaluating the safety and efficacy of erenumab in episodic migraine prevention. In the study, 955 patients were randomized to receive once-monthly subcutaneous placebo or erenumab (70 mg or 140 mg) in a 1:1:1 ratio. Patients enrolled in STRIVE were experiencing an average of 8.3 migraine days per month at baseline. The primary endpoint was change from baseline in mean monthly migraine days over the last three months of the double-blind treatment phase of the study (months 4, 5, 6). Secondary study endpoints included reduction of at least 50 percent from baseline in mean monthly migraine days, change from baseline in mean monthly acute migraine-specific medication days, and reductions from baseline in both mean impact on everyday activities domain and mean physical impairment domain scores on the Migraine Physical Function Impact Diary (MPFID).

ARISE (A Phase 3, RandomIzed, double-blind, placebo-controlled Study to Evaluate the efficacy and safety of erenumab in migraine prevention, 20120297) is a global Phase 3, multicenter, randomized, three-month, double-blind, placebo-controlled study evaluating the safety and efficacy of erenumab in episodic migraine prevention. In the study, 577 patients were randomized to receive once-monthly subcutaneous placebo or erenumab (70 mg) in a 1:1 ratio. Study participants who completed the double-blinded portion had the option to continue in a long-term safety extension. Patients enrolled in ARISE were experiencing an average 8.3 migraine days each month at baseline. The primary endpoint was change from baseline in monthly migraine days from baseline to the last four weeks of the three-month treatment phase (the number of migraine days between weeks 9 and 12). Secondary study endpoints included reduction of at least 50 percent from baseline in monthly migraine days and change from baseline in monthly acute migraine-specific medication treatment days. The MPFID assessed two other secondary endpoints.

About Erenumab

Erenumab is a human monoclonal antibody specifically designed for the prevention of migraine. Erenumab specifically inhibits the receptor of the calcitonin gene-related peptide (CGRP) which is thought to play a causal role in migraine pathophysiology. Erenumab has been studied in several large global, randomized, double-blind, placebo-controlled trials to assess its safety and efficacy in migraine prevention.

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Authored by: Staff

There are 2 comments for this article
  1. david at 11:14 am

    Studies on migrainers reveal 70% have an association with cgrp. Others are associatated with vip and or pacp. So whilst cgrp receptor blocks work for majority of migraineurs a fair amount of time it is clear we dont yet have a full understanding of migraine and are still too focused on hit or miss medication regimes. A more sophisticated model of research and care is needed for migraines can lead to strokes and cost people too much time money and suffering

  2. Judi Lieberman at 5:44 am

    When will this be available in the US?