Erenumab versus topiramate: migraine-related disability, impact and health-related quality of life

Eur J Neurol. 2024 Dec;31(12):e16437. doi: 10.1111/ene.16437. Epub 2024 Aug 12.

Abstract

Background and purpose: HER-MES was the first head-to-head study of erenumab against topiramate (standard of care). This post hoc analysis of the HER-MES study evaluated the effect of erenumab versus topiramate on patient-reported outcomes at week 24.

Methods: Adult patients with episodic or chronic migraine (n = 777) were randomized (1:1) to monthly subcutaneous erenumab (n = 389) or daily oral topiramate (n = 388). Migraine-related disability, as measured by the Headache Impact Test 6 (HIT-6) and Short Form 36 Health Survey version 2 (SF-36v2), was analysed in the entire study cohort and true completers.

Results: In the erenumab group (vs. topiramate), significant improvements were reported in Headache Impact Test 6 total scores (composite populations, -10.88 vs. -7.72; true completers, -11.92 vs. -10.61) and a higher proportion of patients achieved a ≥5-point reduction from baseline with erenumab (composite populations, 72.2% vs. 53.9%; true completers, 79.64% vs. 71.43%). The adjusted mean change from baseline in the SF-36v2 score was greater with erenumab for both physical component summary (composite population, 5.48 vs. 3.63; true completers, 5.95 vs. 5.23) and mental component summary (composite populations, 1.00 vs. -1.18; true completers, 1.74 vs. -0.33). A higher proportion of patients on erenumab versus topiramate had a ≥5-point improvement in SF-36v2 for the physical component summary (composite populations, 47.7% vs. 37.4%; true completers, 52.1% vs. 48.9%) and mental component summary (composite populations, 25.3% vs. 16.8%; true completers, 27.3% vs. 17.7%).

Conclusions: This post hoc analysis demonstrated that patients treated with erenumab had significant improvements in headache impact and quality of life as measured by patient-reported outcomes versus patients treated with topiramate.

Keywords: calcitonin gene‐related peptide; erenumab; migraine‐related disability; patient‐reported outcomes; quality of life.

Publication types

  • Randomized Controlled Trial
  • Comparative Study

MeSH terms

  • Adult
  • Antibodies, Monoclonal, Humanized* / administration & dosage
  • Antibodies, Monoclonal, Humanized* / therapeutic use
  • Calcitonin Gene-Related Peptide Receptor Antagonists / administration & dosage
  • Calcitonin Gene-Related Peptide Receptor Antagonists / pharmacology
  • Calcitonin Gene-Related Peptide Receptor Antagonists / therapeutic use
  • Double-Blind Method
  • Female
  • Fructose / analogs & derivatives
  • Fructose / therapeutic use
  • Humans
  • Male
  • Middle Aged
  • Migraine Disorders* / drug therapy
  • Patient Reported Outcome Measures
  • Quality of Life*
  • Topiramate* / administration & dosage
  • Topiramate* / pharmacology
  • Topiramate* / therapeutic use
  • Treatment Outcome

Substances

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

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