Migraine headaches affect thousands of Americans and millions worldwide. There are several medications that are being prescribed for migraines and for many these do not work well.
In a couple of latest studies, two new drugs for migraine headaches have come up to prove their effectiveness in reducing the severity of the condition in persons who have not responded to traditional therapies. The two drugs are Erenumab and Fremanezumab.
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The studies are both published this week in the New England Journal of Medicine.
Erenumab is one of the anti-migraine drugs that is developed jointly by Novartis and Amgen. They tried the drugs in 955 individuals who suffered from migraines. Fremanezumab, developed by Teva Pharmaceuticals, was similarly tried in 1,130 people. Both drugs showed effectiveness in reducing the frequency and severity of the migraine headaches in nearly 50 percent of the individuals and the manufacturers have submitted the papers and data for approval to the Food and Drug Administration.
The first study with Erenumab was a 6-month study where 40 percent of the participants were given a low-dose monthly injection of the test drug Erenumab. Half of the patients received a high-dose monthly injection of Erenumab. The rest of the participants were given a placebo injection. Those who received the Erenumab injection reported that the frequency and severity of their migraine headaches were reduced by half.
A quarter of patients who received placebo injection also reported a reduction in symptoms. The study reports that the frequency of migraines was around eight days per month before medication for the participants. Those on low dose Erenumab had a reduction of 3.2 days of migraine on average. Those on high dose had a migraine days reduction of 3.7 days while those on placebo had a 1.8 days reduction in the migraine days per month.
In the second study Fremanezumab was given both as a monthly injection and a quarterly injection to the patients. It was compared to placebo. After the drug was administered, 41 percent of those who received the monthly injection showed a reduction of symptoms by half. Only 18 percent of those who received placebo showed a similar reduction in symptoms. Among participants who received an injection every three months, 38 percent showed a half reduction of symptoms. Checking upon migraine headache days, from an average of 13 days a month in all participants, the reduction was 4 to 5 days in those who received fremanezumab injection. The number of days reduced was 2.5 days only with placebo injection.
Both these drugs are produced in the laboratory and act by mimicking the body’s immune cells. Thus, they are called monoclonal antibodies. These agents can bind to a protein within the body called calcitonin gene-related peptide (CGRP). CGRP is released when a person experiences a migraine pain. Blocking this protein could help reduce the severity and frequency of migrains speculate researchers.
Dr. Peter Goadsby, professor of Neurology at University College London and co-author of the erenumab study explained that these drugs are not useful in all individuals. But they may be helpful in persons who have failed to respond to other traditional anti-migraine medications. These could be targeting the migraine trigger he said and that is a novel mechanism of action.
Erenumab would be in the markets to prevent episodic attacks of migraine in individuals who have less than 15 attacks a month. Fremanezumab would be used in persons who have chronic migraines with 15 or more attacks a month. There are two more similar drugs that are being developed by rival companies and these two might be on the shelves by next year speculate the manufacturers.
A Controlled Trial of Erenumab for Episodic Migraine — NEJM