Key clinical point: Early initiation of erenumab demonstrated better long-term efficacy, tolerability, and patient adherence than non-specific oral migraine preventive medications (OMPM) in patients with episodic migraine (EM) and one or two previous preventive treatment failures.
Major finding: At month 12, significantly more patients in the erenumab vs OMPM group completed the initially assigned treatment and also achieved a ≥50% reduction in monthly migraine days (odds ratio 6.48; P < .001). A smaller proportion of patients in the erenumab group vs the OMPM group switched medications (2.2% vs 34.6%) and discontinued treatment due to adverse events (2.9% vs 23.3%).
Study details: Findings are from the APPRAISE trial that included 621 patients with EM (age ≥ 18 years) who had previously failed 1 or 2 preventive treatments and were randomly assigned to receive erenumab (n = 413) and OMPM (n = 208).
Disclosures: This study was funded by Novartis Pharma AG, Basel, Switzerland. Several authors declared themselves as employees of or holding stocks in Novartis, and the other authors declared ties with various sources, including Novartis.
Source: Pozo-Rosich P, Dolezil D, Paemeleire K, et al. Early use of erenumab vs nonspecific oral migraine preventives: The APPRAISE randomized clinical trial. JAMA Neurol. 2024 (Mar 25). doi: 10.1001/jamaneurol.2024.0368 Source