can also prevent migraine from occurring in the first
place. This finding has led to the development and
investigation of possible new medications that target
CGRP in migraine attacks. In May, 2018, erenumab,
the first of these new medications was approved by
the FDA and is now marketed under the brand name
of Aimovig™.
Erenumab is a fully human monoclonal antibody
which works against CGRP molecules and
is produced in laboratories and may be self-
administered by migraine patients as a once-a-
month injection to prevent migraine attacks before
they start. It has its effect by binding to molecules of
CGRP in the body and preventing them from reaching
their targets, thereby interfering with the process of
the underlying migraine mechanism. The clinical
trials have shown robust reductions in the number
of migraine days, decreases in migraine severity, and
improvements in quality of life across populations of
patients who routinely experience migraine attacks.
This medication action appears to persist over time
without losing its effectiveness. And, the overall
safety performance is excellent, demonstrating high
levels of tolerability in thousands of subjects who
received the antibody in the research programs. It is
also encouraging to many patients that there are a
number of other new novel treatments making their
way to the market over the next 2 to 3 years that
hold a lot of promise as well, including three other
CGRP antibodies (eptinezumab, fremanezumab,
galcanezumab), in the same class with erenumab.
Clearly, these are exciting times for patients with
migraine, their families, and their health care
practitioners.
Concern has been expressed over patient
access issues as they pertain to erenumab and
other new treatments soon to be marketed for
migraine prevention, due to expense, coverage,
and availability. The National Headache Foundation
(NHF), the nation’s premier patient organization
since 1970, seeks to deliver on its mission to rid the
world of disabling headache disorders by continually
executing on patient centric education, research,
and advocacy programming. We have recently been
conducting opinion surveys with our thousands
of patient constituents regarding access to care.
One such survey indicated that the most impacted
population of migraine patients have experienced
significant impediments to new treatments due to
cost, coverage, or availability. These patients are
eight times more likely to have been denied access
to one or more treatments. Additionally, they are
twice as likely to be very dissatisfied with their care
and management. Ironically, this is the population of
patients that the prior approval processes employed
by insurance companies should be serving. Yet,
Model of calcitonin gene-related peptide (CGRP)-induced hypersensitivity
www.headaches.org
|
National Headache Foundation
29