Implications of therapy interruption on monthly migraine days and modified migraine disability assessment in patients treated with erenumab for chronic and episodic migraine: SQUARE study interim results

J Neurol. 2024 Aug;271(8):5402-5410. doi: 10.1007/s00415-024-12470-6. Epub 2024 Jun 13.

Abstract

Background: There are limited real-world data in Switzerland examining the impact of erenumab, a fully human IgG2 monoclonal antibody targeting the calcitonin gene-related peptide (CGRP) receptor, on migraine-related quality of life.

Objective: This 18-month interim analysis of 172 patients with episodic or chronic migraine from the SQUARE study provides first prospective insights on the impact of mandatory erenumab treatment interruption, following Swiss-reimbursement requirements, in a real-world clinical setting in Switzerland.

Findings: Recruited patients receiving 70 or 140 mg erenumab underwent treatment interruption on average 11.2 months after therapy onset with a mean duration of 4 months. There were sustained improvements in mean monthly migraine days (MMD) and migraine disability (mMIDAS) during initial treatment with erenumab. Treatment interruption was associated with a temporary worsening of condition. Symptoms ameliorated upon therapy reuptake reaching improvements similar to pre-break within 3 months.

Conclusions: Treatment interruption was associated with a temporary worsening of condition, which improved again after therapy restart.

Keywords: Break; CGRP; Erenumab; Migraine; RWE; Real world evidence.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Antibodies, Monoclonal, Humanized* / administration & dosage
  • Antibodies, Monoclonal, Humanized* / pharmacology
  • Calcitonin Gene-Related Peptide Receptor Antagonists* / administration & dosage
  • Calcitonin Gene-Related Peptide Receptor Antagonists* / pharmacology
  • Chronic Disease
  • Disability Evaluation
  • Female
  • Humans
  • Male
  • Middle Aged
  • Migraine Disorders* / drug therapy
  • Prospective Studies
  • Quality of Life
  • Switzerland
  • Treatment Outcome

Substances

  • erenumab
  • Antibodies, Monoclonal, Humanized
  • Calcitonin Gene-Related Peptide Receptor Antagonists