{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T00:49:12Z","timestamp":1761094152440,"version":"build-2065373602"},"reference-count":26,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2023,5,22]],"date-time":"2023-05-22T00:00:00Z","timestamp":1684713600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["accpjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacotherapy"],"published-print":{"date-parts":[[2023,6]]},"abstract":"Abstract<\/jats:title>Introduction<\/jats:title>With the increased use of erenumab and other calcitonin gene\u2010related peptide antagonists for migraine prevention, increased evidence on long\u2010term efficacy and real\u2010world effectiveness is needed. Some reports of a wearing\u2010off effect or waning efficacy over time have been observed with erenumab use.<\/jats:p><\/jats:sec>Objective<\/jats:title>This study evaluated the change in efficacy of erenumab after initial established benefits for migraine prevention in a veteran population.<\/jats:p><\/jats:sec>Methods<\/jats:title>This retrospective chart review evaluated patients who were prescribed erenumab for migraine prevention at a Veterans Affairs neurology clinic between June 1, 2018, and May 31, 2021. Patients with an initial 50% or greater reduction in mean monthly headache days (MHDs) by 12\u2009weeks after erenumab 70\u2009mg initiation were then followed forward to determine the change in MHDs until erenumab dose was increased, changed to galcanezumab, or by November 30, 2021, to ensure a minimum 6\u2010month follow\u2010up for all patients.<\/jats:p><\/jats:sec>Results<\/jats:title>Ninety\u2010three patients were included for analysis. A significant reduction in mean MHDs from 16.1 to 5.7\u2009days was found by 12\u2009weeks after erenumab 70\u2009mg initiation (p<\/jats:italic>\u2009<\u20090.0001). Following this initial response to erenumab, 69% of patients experienced a significant increase in MHDs over an average time of 7.8\u2009months and required a subsequent dose increase to erenumab 140\u2009mg or change to galcanezumab. The remaining 31% of patients continued erenumab 70\u2009mg monthly with a further nonstatistically significant decline in MHDs.<\/jats:p><\/jats:sec>Conclusions<\/jats:title>A decrease in efficacy with the long\u2010term use of erenumab was observed for the majority of patients evaluated in this analysis. This suggests that patients with initial benefits on lower dose erenumab should be monitored for change to effectiveness.<\/jats:p><\/jats:sec>","DOI":"10.1002\/phar.2812","type":"journal-article","created":{"date-parts":[[2023,5,10]],"date-time":"2023-05-10T15:21:29Z","timestamp":1683732089000},"page":"494-501","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Evaluation of the change in efficacy of erenumab when used long\u2010term for migraine prevention after initial established benefit in a veteran population"],"prefix":"10.1002","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4108-308X","authenticated-orcid":false,"given":"Alison W.","family":"Martin","sequence":"first","affiliation":[{"name":"Ralph H. Johnson Veterans Affairs Medical Center Charleston South Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mara","family":"Cubellis","sequence":"additional","affiliation":[{"name":"Ralph H. Johnson Veterans Affairs Medical Center Charleston South Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,5,22]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(18)30322-3"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000252808.97649.21"},{"issue":"1","key":"e_1_2_8_4_1","first-page":"17","article-title":"Migraine headache prophylaxis","volume":"99","author":"Ha H","year":"2019","journal-title":"Am Fam Physician"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/head.13951"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(19)32504-8"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1177\/0333102418759786"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)32534-0"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1705848"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(17)30083-2"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000004391"},{"key":"e_1_2_8_12_1","first-page":"1","article-title":"Post hoc analysis of clinical trial data and pharmacokinetic data to assess wearing\u2010off of erenumab within monthly treatment cycle","volume":"63","author":"Dodick DW","year":"2022","journal-title":"Headache"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1177\/0333102420946725"},{"volume-title":"Calcitonin Gene\u2010Related Peptide (CGRP) Antibodies (Erenumab\u2010aooe, Galcanezumab\u2010gnlm) Criteria for Use (Revised June 2021)","year":"2018","key":"e_1_2_8_14_1"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-2982.2008.01709.x"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/ene.14715"},{"volume-title":"Pharmacotherapy Self\u2010Assessment Program, 2021 Book 2. 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