Report Evaluates Efficacy, Value of CGRP Inhibitors in Migraine Treatment

The report compared the tolerability and safety of CGRP inhibitors—erenumab, fremanezumab, and galcanezumab—to no preventive treatment or commonly-used preventive therapies.

This article originally appeared on The American Journal of Managed Care.

The Institute for Clinical and Economic Review (ICER) has released their final evidence report

evaluating the effectiveness and value of calcitonin gene-related peptide (CGRP) inhibitors as preventive treatments for patients who suffer from episodic or chronic migraine.

In order to assess the clinical effectiveness, the report compared the tolerability and safety of CGRP inhibitors—erenumab, fremanezumab, and galcanezumab—to no preventive treatment or commonly-used preventive therapies.

For chronic migraine, the report considered 11 trials—1 erenumab trial, 2 fremanezumab trial, and 8 trials of onabotulinum toxin A or topiramate. Following the meta-analyses of the trial results, there were greater reductions in monthly migraine days, monthly headache days, and days using acute medication per month for all interventions versus the placebo; however, there was not a significant difference when comparing CGRP inhibitors to active therapies.

Eighteen trials were considered for episodic migraine, with 8 placebo-controlled trials of CGRP inhibitors assessing erenumab (Sun 2016, STRIVE, ARISE), fremanezumab (Bigal 2015b, HALO-EM), or galcanezumab (Skljarevski 2018, EVOLVE-1, EVOLVE-2), and 10 trials assessing oral preventive therapies.

Overall results showed greater reductions in monthly migraine days, higher odds of 50% response, and greater reductions in days using acute medication per month for all of the interventions versus placebo. The results that compared CGRP inhibitors to oral preventive therapies were found to not be statistically different.

Even more resources pertaining to headaches and migraines can be found on Specialty Pharmacy Times' new sister site, NeurologyLive.

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