Summary

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• Erenumab-aooe (Aimovig) is indicated for the preventive treatment of migraine in adults, demonstrating substantial efficacy in reducing monthly migraine days with dose-dependent responses observed.
• A total of 26 studies were reviewed, providing insights into randomized clinical trials and real-world evidence assessing these preventive treatments on various populations including those with episodic migraine (EM), chronic migraine (CM), medication overuse headache (MOH), and drug-resistant cases.
• Compared to other CGRP monoclonal antibodies such as eptinezumab, fremanezumab, and galcanezumab, Erenumab's performance was slightly lower in some metrics but outperformed others, particularly within real-world settings and specific subpopulations like those suffering from MOH.
• The safety profile of erenumab is impressive, with adverse events being generally mild to moderate and significantly lower than traditional oral preventatives such as topiramate. Serious adverse events are rare across the board for this class of drugs.
• Erenumab has shown consistent effectiveness across diverse patient populations, including patients with EM or CM, indicating broad applicability. It also shows potential as a valuable option for difficult-to-treat migraines where previous treatments have failed.
• Subgroup analyses suggest consistent effectiveness and safety across genders, though more targeted research might be needed to fully understand any gender-specific responses or considerations related to the use of erenumab.
• Comparative analysis suggests that while all CGRP MAbs are effective, there may be variations which could guide personalized treatment decisions based on individual patient suitability considering both efficacy and safety profiles.
• Erenumab presents a favorable benefit-risk ratio when compared against established treatments like topiramate, marking it an advancement in prophylaxis against both episodic and chronic migraines due to its potent efficacy combined with superior tolerability profiles.