To evaluate real-world effectiveness of erenumab compared with oral preventive medications (OPM) among migraine patients.

Migraine is a prevalent, debilitating chronic disease, with a high global burden. Aimovig^® (erenumab) is a first-in-class calcitonin gene-related peptide receptor antagonist, approved in the US for the preventive treatment of migraine in adults.

Using the US Optum’s de-identified Clinformatics^® Data Mart Database, migraine patients initiating erenumab were identified between May 1, 2018 and September 30, 2019 and those initiating OPM between May 1, 2015 and April 30, 2018. Erenumab and OPM (anticonvulsants, antidepressants, antihistamines, ARBs, beta blockers, calcium channel blockers, and ergots) cohorts were matched using the propensity score (PS) method with stratification. Any acute medication use (AMU), healthcare resource utilization (HCRU), and a composite endpoint of emergency room visits, in-patient visits, and outpatient visits with AMU during the 6-month post-index period were compared with PS-matched data. A sensitivity analysis was performed using inverse probability of treatment weighting with 1:3 randomized PS matched data of erenumab vs OPM cohort.

Data for 2,343 matched erenumab and OPM treated patients were analyzed (mean age 49.7 vs 49.2 years respectively, 88.4% female for both cohorts). At 6 months, migraine-specific AMU and HCRU were significantly lower for erenumab users compared with OPM users. For the composite outcome, a significantly lower mean number of events was also observed for the erenumab cohort (0.40 vs 0.57; rate ratio: 0.71 [95% CI: 0.65-0.77], p<0.0001). Similarly, a significantly lower proportion of patients with any of the three events was observed (30.5% vs 40.7%; odds ratio: 0.64 [95% CI: 0.56-0.73], p<0.0001).

These real-world data highlight that erenumab significantly reduces migraine-specific AMU and HCRU among migraine patients, hence significantly reduces burden of the disease as well as overall cost. The magnitude of reductions was significantly greater in erenumab than OPM treated patients.