|Other names||AMG-334, erenumab-aooe|
|Drug class||CGRPR blocker|
|Main uses||Prevent migraines|
|Side effects||Constipation, muscle spasms|
|Elimination half-life||28 days|
|Chemical and physical data|
|Molar mass||145871.98 g·mol−1|
Erenumab, sold under the brand name Aimovig, is a medication used to prevent migraine headaches. It is used in those who have at least 4 headaches a month. It is given by injection under the skin.
Common side effects include constipation and muscle spasms. Other side effects may include swelling due to fluid retention. While there is no evidence of harm with use in prenancy, such use has not been well studied. It is a monoclonal antibody that binds to and blocks calcitonin gene-related peptide receptor (CGRPR).
Erenumab was approved for medical use in the United States and Europe in 2018. In the United Kingdom it costs about £390 every 4 weeks as of 2021. This amount in the United States is about 630 USD.
Erenumab was shown not to interact with ethinyl estradiol, norgestimate or the migraine drug sumatriptan. It is expected to generally have a low potential for interactions because it is not metabolized by cytochrome P450 enzymes.
Mechanism of action
After subcutaneous injection, the erenumab has an estimated bioavailability of 82%. Highest blood plasma concentrations are reached after four to six days. Like other proteins, the substance is degraded by proteolysis to small peptides and amino acids. It has an elimination half-life of 28 days.
In the phase III STRIVE clinical trial 955 patients were divided into three groups in a 1:1:1 ratio. Each group was injected subcutaneously monthly with 0, 70 or 140 mg erenumab over a period of 6 months. The results were measured as mean monthly migraine days in months 4, 5, and 6. At baseline the patients experienced between 4 and 14 migraine days per month with an average of 8.3. The medication significantly reduced the number of migraine days per month by 3.2 in the 70-mg group and 3.7 in the 140-mg group, versus 1.8 in the placebo (0-mg) group.
The United States Food and Drug Administration (FDA) approved the medication for the preventive treatment of migraine in adults on May 17, 2018. It was the first of four CGRPR antagonists to be approved that year. The list price was reported to be US$6,900 per year. It was approved for medical use in the European Union on July 26, 2018.
In the United Kingdom, Erenumab was approved by the Scottish Medicines Consortium, but the National Institute of Health and Care Excellence rejected the drug on the basis that its cost-effectiveness was not sufficiently proven.
- Other antibodies blocking the calcitonin gene-related peptide (CGRP) pathway:
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