Original Title: Erenumab en prevención de migraña

Authors' recommendations: CONCLUSIONS Low-quality evidence suggests that preventive treatment with erenumab in patients refractory to all the available therapeutic schemes might reduce the number of monthly migraine days by at least 50 and 75% when compared to baseline at three-month follow-up. This evidence comes from clinical trials against placebo in treatment-naïve or partially refractory patients and with a six to twelve-month follow-up. The effect on quality of life was not consistent for those patients against placebo. On the one hand, it could significantly improve patient-reported outcomes in the Headache Impact Test (HIT-6TM) and two sub-domains of the Migraine-Specific Quality of Life Questionnaire at six-month follow-up. However, this benefit was not observed in the modified Migraine Disability Assessment Questionnaire. No evidence comparing erenumab with other active therapeutic options for migraine prevention (beta-blockers, antidepressants, anticonvulsants, calcium-channel blockers and botulinum toxin) was identified. With the exception of one clinical practice guideline, the rest of the guidelines surveyed, do not mention erenumab as preventive treatment for migraine. Of the coverage policies analyzed, three high-income countries decided not to include erenumab among its benefits, because there is no comparative evidence against other valid alternatives, its long-term effect is unknown and/or its cost-effectiveness is not acceptable. Other two coverage policies from high-income countries decided to include it; one, for patients refractory to all therapeutic options and the other, with significant restrictions for its indication. The economic assessments surveyed come from high-income countries and they suggest that in adult patients with migraine with or without aura, and indication for preventive treatment, erenumab treatment is not a cost-effective option when compared to placebo or botulinum toxin A. A preliminary report from the National Institute for Health and Clinical Excellence (NICE) also concluded that erenumab is not cost-effective for the preventive treatment of migraine.

Project Status: Completed

Year Published: 2019

URL for published report: https://www.iecs.org.ar/home-ets/

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Argentina

Organisation Name: Institute for Clinical Effectiveness and Health Policy

Contact Address: Dr. Emilio Ravignani 2024, Buenos Aires - Argentina, C1414 CABA

Contact Name: info@iecs.org.ar

Contact Email: info@iecs.org.ar

Copyright: <p>Institute for Clinical Effectiveness and Health Policy (IECS)</p>