erenumab

Erenumab, sold under the brand name Aimovig, is a human monoclonal antibody that targets the calcitonin gene-related peptide (CGRP) receptor. It is approved for the preventive treatment of migraine in adults. The medicine is given by subcutaneous injection once monthly, with available doses of 70 mg or 140 mg, and patients may self-administer after proper training.

Mechanism of action: Erenumab binds to the CGRP receptor, blocking CGRP from activating the receptor. By inhibiting this pathway, it aims to reduce migraine-related vasodilation and trigeminovascular activation, which are believed to contribute to migraine attacks.

Indications and usage: Erenumab is indicated for adults with migraine, including episodic migraine and chronic migraine. It is a preventive therapy and is not approved for acute treatment or for other headache disorders such as cluster headaches. Pregnancy should be discussed with a clinician, as data are limited.

Clinical efficacy: In phase 3 trials, erenumab significantly reduced monthly migraine days compared with placebo. The magnitude of benefit varied by patient population and dose, with reductions typically in the range of about 1 to 2 days per month and higher responder rates observed at the 140 mg dose in some studies.

Safety and regulatory status: Erenumab is generally well tolerated. Common adverse events include injection-site reactions and constipation; rare hypersensitivity reactions and hypertension have been reported. There is no indication of major liver toxicity, and drug interactions are not prominent. It was approved by the FDA in 2018 for adults and has since been approved in other regions for episodic and chronic migraine, with access subject to insurance coverage and local guidelines.