ARISE: A Phase 3 randomized trial of erenumab for episodic migraine

David W. Dodick, Messoud Ashina, Jan Lewis Brandes, David Kudrow, Michel Lanteri-Minet, Vera Osipova, Kerry Palmer, Hernan Picard, Daniel D. Mikol, Robert A. Lenz

Research output: Contribution to journalArticle

123 Scopus citations

Abstract

Background: Calcitonin gene-related peptide plays an important role in migraine pathophysiology. Erenumab, a human monoclonal antibody that inhibits the calcitonin gene-related peptide receptor, is being evaluated for migraine prevention. Methods: In this randomized, double-blind, placebo-controlled, phase 3 study, 577 adults with episodic migraine were randomized to placebo or 70 mg erenumab; 570 patients were included in efficacy analyses. Primary endpoint was change in monthly migraine days. Secondary endpoints were ≥50% reduction in monthly migraine days, change in acute migraine-specific medication treatment days, and ≥5-point reduction in Physical Impairment and Impact on Everyday Activities domain scores measured by the Migraine Physical Function Impact Diary. All endpoints assessed change from baseline at month 3. Results: Patients receiving erenumab experienced −2.9 days change in monthly migraine days, compared with −1.8 days for placebo, least-squares mean (95% CI) treatment difference of −1.0 (−1.6, −0.5) (p < 0.001). A ≥ 50% reduction in monthly migraine days was achieved by 39.7% (erenumab) and 29.5% (placebo) of patients (OR:1.59 (95% CI: 1.12, 2.27) (p = 0.010). Migraine-specific medication treatment days were reduced by −1.2 (erenumab) and −0.6 (placebo) days, a treatment difference of −0.6 (−1.0, −0.2) (p = 0.002). The ≥5-point reduction rates in Migraine Physical Function Impact Diary – Physical Impairment were 33.0% and 27.1% (OR:1.33 (0.92, 1.90) (p = 0.13) and in Migraine Physical Function Impact Diary – Everyday Activities were 40.4% and 35.8% (OR:1.22 (0.87, 1.71) (p = 0.26). Safety and adverse event profiles of erenumab were similar to placebo. Most frequent adverse events were upper respiratory tract infection, injection site pain, and nasopharyngitis. Conclusions: As a preventive treatment of episodic migraine, erenumab at a dosage of 70 mg monthly significantly reduced migraine frequency and acute migraine-specific medication use. (Funded by Amgen). Trial registration: ClinicalTrials.gov, NCT02483585.

Original languageEnglish (US)
Pages (from-to)1026-1037
Number of pages12
JournalCephalalgia
Volume38
Issue number6
DOIs
StatePublished - May 1 2018

Keywords

  • Erenumab
  • calcitonin gene-related peptide
  • efficacy
  • migraine
  • safety

ASJC Scopus subject areas

  • Clinical Neurology

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    Dodick, D. W., Ashina, M., Brandes, J. L., Kudrow, D., Lanteri-Minet, M., Osipova, V., Palmer, K., Picard, H., Mikol, D. D., & Lenz, R. A. (2018). ARISE: A Phase 3 randomized trial of erenumab for episodic migraine. Cephalalgia, 38(6), 1026-1037. https://doi.org/10.1177/0333102418759786