First treatment designed specifically to prevent migraine gets European licence

The first ever drug specifically designed to prevent migraines in adults has been approved by the European Medicines Agency (EMA), and the head of the Oxford Headache Centre has said the news represents a new approach in treating the condition.

The EMA granted a licence for the use of erenumab, manufactured by Novartis under the name of Aimovig, the first and only licensed preventative treatment designed specifically for migraine. The drug blocks the calcitonin gene-related peptide (CGRP) receptor, thought to be involved in the transmission of the pain signals associated with migraine.

Professor Zameel Cader, Consultant Neurologist at the Oxford University Hospitals NHS Foundation Trust and Director of the Oxford Headache Centre at the John Radcliffe Hospital, said: "It's great news. It represents a new approach for the clinical community in our ability to treat those that suffer most with migraine."

"Migraine sufferers who have not responded to the current therapies or find that they cause lots of side-effects have been waiting for a new therapy. This is a great day for them.

"Most of the drugs we use currently have been developed for other purposes, such as depression or epilepsy, and have been found coincidentally to be able to treat migraine. This one's been specifically designed to prevent migraine, and that's really quite special.

"Erenumab has been shown to reduce the average number of monthly migraine days in both episodic and chronic migraine patients, so potentially there's a large number of people who would benefit from this therapy," he added. 

Prof Cader, who is supported by the NIHR Oxford Biomedical Research Centre, has carried out clinical trials on CGRP antibody therapy, as well as the basic science research that underpins this development.

Migraine is a complex and debilitating neurological condition that affects each individual differently. Latest information shows that over 610,000 people in the UK are estimated to experience chronic migraine (15 or more headache days per month, of which eight involve migraine symptoms), having a serious long-term impact on day-to-day activities. 

An estimated £9.7 billion a year is lost in the UK alone due to migraine through direct and indirect costs, yet migraine remains the least publicly funded of all neurological illnesses relative to its economic impact.

Initial decisions on erenumab for the prevention of migraine from the National Institute for Health and Care Excellence (NICE) and the Scottish Medicine Consortium (SMC) are expected in 2019. 

"Being optimistic, I would hope that we would be able to start prescribing this on the NHS in the early part of next year," Prof Cader said.

Novartis said it was working closely with all stakeholders to ensure eligible patients could start benefiting from this treatment as quickly as possible, adding that it was developing a bespoke programme and range of resources to provide support to patients and healthcare professionals.