Erenumab aooe: a milestone for the preventive treatment of migraine
DOI:
https://doi.org/10.18203/2320-6012.ijrms20202295Keywords:
CGRP receptor, NSAIDs, Osmophobia, Phonobhobia, PhotophobiaAbstract
Migraine is a complex neurological condition, which can affect the whole body and can result in many symptoms as nausea, vomiting, photophobia (Increased sensitivity to light), phonobhobia (Increased sensitivity to sound) and osmophobia (Increased sensitivity to smell). Neurological symptoms that include visual disturbances such as blind spots, distorted vision, flashing lights or zigzag patterns. Other common symptoms includes- dizziness, vertigo, tingling sensations in the limbs, an inability to concentrate, confusion, difficulty in speaking, paralysis or loss of consciousness (in very rare cases). These symptoms, often called ‘aura’. Migraine attacks may differ in their frequency, duration and severity, although, normally they last between 4 and 72 hours, and most people are symptom-free between attacks. There are many drugs for the treatment of acute attack of migraine which can be divided into mild, moderate and severe attacks. In mild case NSAIDs like Paracetamol, Ibuprofen are prescribed. In moderate cases Anti-emetics like metoclopramide, domperidone can be prescribe with combinations of NSAIDs or triptans as sumatriptan. In case of severe cases triptans can be prescribed with ergot alkaloids and antiemetics. Following drugs are prescribed for the prophylaxis of migraine as sodium valproate, amitriptyline (Tricyclic antidepressant), propranolol and metoprolol (beta blockers). Erenumab-aooe is a calcitonin gene-related peptide receptor antagonist. It is specifically indicated for the preventative treatment of migraine in adults. Erenumab-aooe is supplied as an injection for subcutaneous use. The recommended dosage is 70 mg injected subcutaneously once monthly. Some patients may benefit from a dosage of 140 mg injected subcutaneously once monthly, which is administered as two consecutive subcutaneous injections of 70 mg each. Erenumab-aooe is a human monoclonal antibody that binds to the calcitonin gene-related peptide (CGRP) receptor and antagonizes CGRP receptor function.
References
Aminoff, Roger P. Simon, David A. Greenberg, Michael J. Clinical Neurology. 7 ed. New York, N.Y: Lange Medical Books/McGraw-Hill. 2009:85-88.
Piane M, Lulli P, Farinelli I, Simeoni S, De Filippis S, Patacchioli FR, et al. Genetics of migraine and pharmacogenomics: some considerations. J Head Pain. December 2007;8(6):334-9.
Bartleson JD, Cutrer FM. Migraine update. Diagnosis and treatment. Minn Med. May 2010:93(5):36-41.
Stovner LJ, Zwart JA, Hagen K, Terwindt GM, Pascual J. Epidemiology of headache in Europe. Eur J Neurol. 2006 Apr;13(4):333-45.
Bigal ME, Lipton RB. The prognosis of migraine. Current Opinion Neurol. 2008 Jun 1;21(3):301-8.
Gutman SA. Quick reference neuroscience for rehabilitation professionals: 2nd ed The essential neurologic principles underlying rehabilitation practice. Slack Incorporated; 2008;231.
Baskin SM, Lipchik GL, Smitherman TA. Mood and anxiety disorders in chronic headache. Headache: J Head Face Pain. 2006 Oct;46:S76-87.
Rae-Grant D. Joanne Lynn, Herbert B. Newton, Alexander D. The 5-minute neurology consult. Philadelphia: Lippincott Williams & Wilkins. 2004:26.
Tintinalli, Judith E. Emergency Medicine: A Comprehensive Study Guide (Emergency Medicine (Tintinalli)). New York: McGraw-Hill Companies. 2010;1116-1117.
Bigal, ME; Arruda, MA. Migraine in the pediatric population evolving concepts". Headache. July 2010;50(7):1130–43.
Kelman L. The postdrome of the acute migraine attack. Cephalalgia. February 2006;26(2):214-20.
Halpern, Audrey L, Silberstein, Stephen D. Ch. 9: The Migraine Attack-A Clinical Description. In Kaplan PW, Fisher RS. Imitators of Epilepsy 2nd ed. New York: Demos Medical. 2005;83-88.
Schürks M. Genetics of migraine in the age of genome-wide association studies. J Headache Pain. 2012;13(1):1-9.
Modi S, Lowder DM. Medications for migraine prophylaxis. Am Fam Phys. January 2006:73(1):72-8.
Diener HC, Limmroth V. Medication-overuse headache: a worldwide problem. Lancet Neurol August 2004;3(8):475-83.
Kaniecki R, Lucas S. Treatment of primary headache. preventive treatment of migraine. Standards of care for headache diagnosis and treatment. Chicago: Nat Head Found. 2004;40-52.
Loder E, Burch R, Rizzoli P. The 2012 AHS/AAN guidelines for prevention of episodic migraine: a summary and comparison with other recent clinical practice guidelines. Headache: J Head Face Pain. 2012 Jun;52(6):930-45.
Rajapakse T, Pringsheim T. Nutraceuticals in migraine: a summary of existing guidelines for use. Headache: J Head and Face Pain. 2016 Apr;56(4):808-16.
Teigen L, Boes CJ. An evidence-based review of oral magnesium supplementation in the preventive treatment of migraine. Cephalalgia. 2015 Sep;35(10):912-22.
Silberstein SD, Holland S, Freitag F, Dodick DW, Argoff C, Ashman E. Evidence-based guideline update: pharmacologic treatment for episodic migraine prevention in adults: report of the Quality Standards Subcommittee of the American Academy of Neurology and the American Headache Society. Neurology. 2012 Apr 24;78(17):1337-45.
Goadsby PJ, Reuter U, Hallström Y, Broessner G, Bonner JH, Zhang F, et al. A controlled trial of erenumab for episodic migraine. New England J Med. 2017 Nov 30;377(22):2123-32.
