Erenumab Improves Functional Outcomes of Episodic Migraine: LIBERTY Trial
Erenumab is a fully human monoclonal antibody that inhibits the canonical calcitonin gene-related peptide (CGRP) receptor. A recent study suggests that erenumab improves functional outcomes in patients with EM in whom 2–4 preventives were not useful. The research has been published in the Journal of Neurology, Neurosurgery & Psychiatry on April 15, 2021.
Clinical studies have demonstrated the efficacy and safety of erenumab in patients with episodic migraine (EM) and chronic migraine (CM) including in those with prior preventive migraine treatment failures. Results from the Phase 3b LIBERTY study confirmed that erenumab is a potential treatment for the management of patients with EM in whom 2–4 preventives were not useful. Michel Lanteri-Minet and his team conducted an analysis to evaluate the effect of erenumab on patient-reported, functional outcomes in patients with episodic migraine (EM) in whom 2–4 preventives were not useful from the Phase 3b LIBERTY study.
Phase 3b LIBERTY study included 246 patients with EM with 2–4 prior failed preventives who were randomised 1:1 to subcutaneous erenumab 140 mg or placebo every 4 weeks for 12 weeks. In this analysis, the researchers evaluated Migraine Physical Function Impact Diary (MPFID), Headache Impact Test (HIT-6) and Work Productivity and Activity Impairment (WPAI) scores at Week 12.
Key findings of the study were:
- By the end of 12 weeks, the researchers found that erenumab significantly improved MPFID-Physical Impairment (PI) and Everyday Activities (EA) scores than placebo (treatment difference (TD) MPFID-PI: −3.5); MPFID-EA: −3.9).
- They observed that patients on erenumab were more likely to have a ≥5-point reduction in MPFID score (odds ratio [OR] vs placebo; MPFID-EA: 2.1; MPFID-PI: 2.5).
- They found that about 46.2% of patients in the erenumab group had a ≥5-point reduction in HIT-6 total score from baseline, which was nearly 2 times higher compared with 26.6% of patients in the placebo group (OR, 2.4).
- In three out of four WPAI domains, they reported that erenumab showed improvement versus placebo.
The authors concluded, "These findings, obtained via the use of patient-reported outcomes (PROs)—the MPFID-EA and PI, HIT-6, and WPAI questionnaires—corroborate the efficacy observed with erenumab in LIBERTY on traditional measures of treatment efficacy (such as the number of migraine days)."
They further added, "The findings of these analyses add to previous erenumab efficacy and safety data obtained from the LIBERTY study. They show that erenumab exerts a positive effect on patient functioning and work productivity, as assessed by PRO measures among patients with EM in whom 2–4 preventives had not been useful."
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