New drug can halve duration of migraines

Andrew Cummings
December 1, 2017

"This therapeutic approach offers new hope for people whose migraines can not be treated with existing medicine", says Stephen D. Silberstein, M.D., principal investigator of the HALO CM trial, Professor of Neurology and Director of the Jefferson Headache Center at the Vicki & Jack Farber Institute for Neuroscience at Thomas Jefferson University Hospital.

The drugs are the first preventive medicines developed specifically for migraines.

Migraines are seriously painful, and while most of us get them pretty rarely, there are some people who deal with debilitating headaches each and every day.

"If approved, this treatment would provide physicians with an important new tool to help prevent migraine, reduce a patient's migraine load, and potentially help patients return to normal", said Silberstein.

Study results published Wednesday in the New England Journal of Medicine show that fremanezumab reduced the number of days patients experience headache by an average of 4.3 days with quarterly treatment and 4.6 days with monthly treatment.

Migraines are characterised by an intense, throbbing headache, sensitivity to light and noise, nausea, vomiting, low energy, and visual disturbances. They can leave people unable to work or do simple tasks.

Novartis and Amgen's human monoclonal antibody erenumab has succeeded in a phase 3 study by demonstrating significant and sustained efficacy in the prevention of episodic migraine.

Of the number who took part in the trial, 317 were assigned to the 70-mg erenumab group, 319 to the 140-mg erenumab group, and 319 to the placebo group. Migraine days were cut by ≥50% for half of the patients in the 140mg group, by 43.3% for the 70mg group, and by 26.6% for the placebo group.

Erenumab was shown to deliver clinically meaningful and statistically significant benefits over six months, with reduced migraine days and acute medication use. Only 18.1 percent of the placebo group, by comparison, had 50 percent reduction in moderate headaches per month. "I have three kids, so for me it meant having more days when I was able to live my everyday life, cook a meal at home, go to events at school".

The second antibody, fremanezumab, is developed by Teva pharmaceuticals and trialed on 1130 patients with chronic migraine.

No worrisome side effects emerged, but the studies were very short, so long-term safety and effectiveness are unknown.

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