To assess the sustained efficacy of erenumab through 52 weeks of treatment in patients with episodic migraine who had failed prior preventive therapies (EM_TF).

Erenumab has demonstrated efficacy and safety in migraine prevention studies.

Patients were randomized (1:1:1; n=955) to placebo or erenumab 70mg or 140mg monthly during the 24-week, double-blind treatment phase (DBTP) of the STRIVE study (NCT02456740). At week 24, 845 patients were re-randomized (1:1) to erenumab 70mg or 140mg for the subsequent 28-week, dose-blinded active treatment phase (ATP). The EM_TF subgroup was defined as patients who failed ≥ one prior preventive therapy due to lack of efficacy/tolerability. Change from baseline in monthly migraine days (MMD) and monthly acute migraine-specific medication treatment days (MSMD) were assessed at week 52, as well as the proportion of patients achieving ≥50%/≥75%/100% MMD reduction in the last month of ATP. Patients were analyzed by dose received during the ATP (70mg or 140mg) for efficacy and safety reporting, irrespective of DBTP treatment.

Of the 845 patients who completed the DBTP and were re-randomized into the ATP, 343 (41%) patients had failed ≥ one prior preventive therapy. In EM_TF, baseline MMD was 8.7(0.1); mean (SE) change from baseline to week 52 was  ? 3.4(0.4) and  ? 4.2(0.3) for the 70mg and 140mg erenumab dose groups, respectively. Baseline MSMD was 4.9(0.2); mean (SE) change from baseline to week 52 in MSMD was  ? 1.9(0.3) and  ? 2.5(0.2) for 70mg and 140mg erenumab, respectively.  In total, 52.3% of EM_TF patients on erenumab 70mg and 55.0% of EM_TF patients on erenumab 140mg achieved ≥50% reduction from baseline in MMD at Week 52; 29% and 33% achieved ≥75% reduction, and 12% and 16% achieved 100% reduction.

Erenumab provided sustained efficacy through week 52 in patients with episodic migraine who had failed prior preventive migraine therapy.