Erenumab

Erenumab, sold under the brand name Aimovig, is a medication which targets the calcitonin gene-related peptide receptor (CGRPR) for the prevention of migraine.[3][4][5] It is administered by subcutaneous injection.[3][4]

Erenumab
A standard 70mg/mL Aimovig autoinjector
A standard 70mg/mL Aimovig autoinjector
Monoclonal antibody
TypeWhole antibody
SourceHuman
TargetCGRPR
Clinical data
Trade namesAimovig
Other namesAMG-334, erenumab-aooe
AHFS/Drugs.comMonograph
MedlinePlusa618029
License data
Pregnancy
category
Routes of
administration		Subcutaneous injection
ATC code
Legal status
Legal status
Pharmacokinetic data
Bioavailability82% (estimated)
MetabolismProteolysis
Elimination half-life28 days
Identifiers
CAS Number
DrugBank
ChemSpider
  • none
UNII
KEGG
ChEMBL
Chemical and physical data
FormulaC6472H9964N1728O2018S50
Molar mass145871.98 g·mol−1

Erenumab, which was developed by Amgen and Novartis,[5] was approved in May 2018, and was the first CGRPR antagonist to be approved by the U.S. Food and Drug Administration.[6] In 2020, it was the 234th most commonly prescribed medication in the United States, with more than 1 million prescriptions.[7][8]

Medical uses

Erenumab is indicated for the prevention of migraine in adults.[3][4]

Side effects

Common side effects are constipation, pruritus, muscle spasms, as well as mild and mostly transient reactions at the injection site.[4][9]

Interactions

Erenumab was shown not to interact with ethinylestradiol, norgestimate or the migraine drug sumatriptan. It is expected to generally have a low potential for interactions because it is not metabolized by cytochrome P450 enzymes.[9]

Pharmacology

Mechanism of action

Erenumab is a fully human monoclonal antibody blocking the calcitonin gene-related peptide receptor (CGRPR).[3][10][11]

Pharmacokinetics

After subcutaneous injection, the erenumab has an estimated bioavailability of 82%. Highest blood plasma concentrations are reached after four to six days. Like other proteins, the substance is degraded by proteolysis to small peptides and amino acids. It has an elimination half-life of 28 days.[9]

History

Erenumab was developed by Amgen Inc. in conjunction with Novartis.[5]

In the phase III STRIVE clinical trial 955 patients were divided into three groups in a 1:1:1 ratio. Each group was injected subcutaneously monthly with 0, 70 or 140 mg erenumab over a period of 6 months. The results were measured as mean monthly migraine days in months 4, 5, and 6. At baseline the patients experienced between 4 and 14 migraine days per month with an average of 8.3. The medication significantly reduced the number of migraine days per month by 3.2 in the 70-mg group and 3.7 in the 140-mg group, versus 1.8 in the placebo (0-mg) group.[5][12]

Society and culture

Economics

The list price was reported to be US$6,900 per year.[13]

In the United Kingdom, Erenumab was approved by the Scottish Medicines Consortium, but the National Institute for Health and Care Excellence rejected the drug on the basis that its cost-effectiveness was not sufficiently proven.[14][15]

The United States Food and Drug Administration approved the medication for the preventive treatment of migraine in adults in May 2018. It was the first CGRPR antagonist to be approved.[6] It was approved for medical use in the European Union on July 26, 2018.[4][16]

Names

Erenumab is the international nonproprietary name and the United States Adopted Name.[17][18]

References
  1. "Erenumab (Aimovig) Use During Pregnancy". Drugs.com. 17 April 2019. Archived from the original on 29 November 2020. Retrieved 5 May 2020.
  2. "Summary Basis of Decision (SBD) for Aimovig". Health Canada. Archived from the original on 31 May 2022. Retrieved 29 May 2022.
  3. "Aimovig- erenumab-aooe injection Aimovig- erenumab-aooe injection, solution". DailyMed. 19 August 2022. Archived from the original on 5 July 2022. Retrieved 29 September 2022.
  4. "Aimovig EPAR". European Medicines Agency (EMA). Archived from the original on 17 October 2020. Retrieved 4 May 2020.
  5. Goadsby PJ, Reuter U, Hallström Y, Broessner G, Bonner JH, Zhang F, et al. (November 2017). "A Controlled Trial of Erenumab for Episodic Migraine". The New England Journal of Medicine. 377 (22): 2123–2132. doi:10.1056/NEJMoa1705848. PMID 29171821.
  6. "FDA Approves First-in-Class Drug Erenumab (Aimovig) for Migraine Prevention". Medscape. 17 May 2018. Archived from the original on 25 September 2019. Retrieved 21 May 2018.
  7. "The Top 300 of 2020". ClinCalc. Retrieved 7 October 2022.
  8. "Erenumab - Drug Usage Statistics". ClinCalc. Retrieved 7 October 2022.
  9. "Aimovig: EPAR - Product Information" (PDF). European Medicines Agency. 8 August 2018. Archived (PDF) from the original on 6 October 2018. Retrieved 2 May 2019.
  10. "Amgen Presents First-Of-Its-Kind Data At AAN Annual Meeting Reinforcing Robust And Consistent Efficacy Of Aimovig (erenumab) For Migraine Patients With Multiple Treatment Failures" (Press release). Amgen. 17 April 2018. Archived from the original on 11 November 2020. Retrieved 29 September 2022 – via PR Newswire.
  11. Edvinsson L (December 2018). "CGRP Antibodies as Prophylaxis in Migraine". Cell. 175 (7): 1719. doi:10.1016/j.cell.2018.11.049. PMID 30550780.
  12. Erenumab to prevent migraine: results from phase III STRIBE" Archived 13 August 2018 at the Wayback Machine, Pharma World, December 14, 2017.
  13. Kolata G (17 May 2018). "F.D.A. Approves First Drug Designed to Prevent Migraines". The New York Times. Archived from the original on 11 May 2020. Retrieved 26 September 2019.
  14. Gallagher J (26 September 2019). "'Life-changing' migraine drug rejected for NHS". BBC News Online. Archived from the original on 31 July 2021. Retrieved 26 September 2019.
  15. "New migraine drug not cost-effective NICE says in draft guidance". NICE. Archived from the original on 1 November 2020. Retrieved 26 September 2019.
  16. "First drug to prevent chronic migraines approved by EU". The Guardian. 31 July 2018. Archived from the original on 19 September 2018. Retrieved 19 September 2018.
  17. "Statement On A Nonproprietary Name Adopted By The USAN Council - Erenumab" (PDF). American Medical Association. 24 November 2015. Archived (PDF) from the original on 4 November 2018. Retrieved 4 November 2018.
  18. World Health Organization (2016). "International Nonproprietary Names for Pharmaceutical Substances (INN). Proposed INN: List 115" (PDF). WHO Drug Information. 30 (2). Archived (PDF) from the original on 5 February 2018. Retrieved 30 September 2022.
  • "Erenumab". Drug Information Portal. U.S. National Library of Medicine.
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