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A 65-year-old lady with a background of type 2 diabetes, hyperlipidaemia and chronic immune thrombocytopenia presented to us with a 2-week history of generalized malaise and myalgia. Shortly after the onset of myalgia, she was noted to have reduced urine output and the urine was described as dark in colour. Her regular medications included prednisolone, danazol, simvastatin, metformin, and human insulin. Upon further questioning, the patient admitted that her compliance to simvastatin and danazol used to be poor. However, she recently started to take both medications regularly after repeated education.
Pearl Toh, 30 Jan 2018
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26 Dec 2017
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Rachel Soon, 21 Feb 2018

MIMS Pharmacist sits down with pharmacist researcher Dr Mai Chun Wai to find out more about his work in drug discovery, including his investigations of Antarctic soil microorganisms.

Erenumab shows potential in reducing episodic migraine

Roshini Claire Anthony
21 May 2018

Individuals who have failed between two and four preventive therapies for episodic migraine may derive benefit from a once-a-month dose of erenumab, according to results of the phase IIIb LIBERTY* study.

“Our study found that [the calcitonin gene-related peptide receptor inhibitor] erenumab reduced the average number of monthly migraine headaches by more than 50 percent for nearly a third of study participants. That reduction in migraine headache frequency can greatly improve a person’s quality of life,” said study author Dr Uwe Reuter from The Charité – University Medicine Berlin in Germany who presented the findings at the recent meeting of the American Academy of Neurology (AAN 2018).

Researchers of this double-blind trial randomized 246 patients who had failed multiple (two to four) preventive migraine treatments to receive once-monthly injections of the fully human monoclonal antibody erenumab (140 mg) or placebo for 12 weeks. Of these, 38.6, 37.8, and 22.8 percent of patients had failed two, three, and four prior preventive treatments.

At baseline, patients had a mean of 9.3 migraine days per month and had 4.6 days per month of exposure to medications specifically to stop acute migraine attacks.   

At 12 weeks, a greater proportion of patients treated with erenumab experienced ≥50 percent reduction in mean monthly migraine days compared with those treated with placebo (30.3 percent vs 13.7 percent, odds ratio, 2.73, 95 percent confidence interval [CI], 1.43–5.19; p=0.002). [AAN 2018, abstract 009]

At week 12, patients who had received erenumab had fewer mean monthly migraine days compared with those who had received placebo (mean difference, -1.61, 95 percent CI, -2.70 to -0.52; p=0.004) as well as fewer monthly acute migraine-specific medication days (mean difference, -1.73, 95 percent CI, -2.46 to -1.01; p<0.001).

Researchers found that the safety and tolerability of erenumab was similar to that of placebo and there were no adverse event-related treatment discontinuations among patients who received erenumab.

According to the researchers, adherence to currently available oral treatments to prevent migraine is low due to lack of efficacy or tolerability.

“The people we included in our study were considered more difficult to treat, meaning that up to four other preventative treatments hadn’t worked for them,” said Reuter.

“Our results show that people who thought their migraines were difficult to prevent may actually have hope of finding pain relief,” he said, highlighting the importance of further research into identifying which patient population would derive the most benefit from this treatment option as well as the length of time this positive effect is seen.

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Most Read Articles
Prof. Cheuk-Chun Szeto, Dr. Winston W. S. Fung, 25 Jan 2018
A 65-year-old lady with a background of type 2 diabetes, hyperlipidaemia and chronic immune thrombocytopenia presented to us with a 2-week history of generalized malaise and myalgia. Shortly after the onset of myalgia, she was noted to have reduced urine output and the urine was described as dark in colour. Her regular medications included prednisolone, danazol, simvastatin, metformin, and human insulin. Upon further questioning, the patient admitted that her compliance to simvastatin and danazol used to be poor. However, she recently started to take both medications regularly after repeated education.
Pearl Toh, 30 Jan 2018
Use of statins may not be neuroprotective, in contrast to findings from previous observational studies. On the contrary, fungus-derived or lipophilic statins appeared to be associated with a slightly increased risk of Alzheimer's disease (AD) compared with synthetic and hydrophilic statins, suggests a new study based on real-world clinical practice data.
26 Dec 2017
Supplementation with omega-3 fatty acids in combination with rosuvastatin may yield significant reductions in triglycerides and nonhigh-density lipoprotein (HDL) cholesterol as compared with rosuvastatin monotherapy, according to data from the ROMANTIC (rosuvastatin-omacor in residual hypertriglyceridemia) trial.
Rachel Soon, 21 Feb 2018

MIMS Pharmacist sits down with pharmacist researcher Dr Mai Chun Wai to find out more about his work in drug discovery, including his investigations of Antarctic soil microorganisms.