Erenumab for the prevention of migraine, including the rationale, findings and clinical implications of the LIBERTY Study

Abstract

Many migraine sufferers require preventative treatment to reduce the frequency of acute attacks; however, current therapeutic options for migraine prophylaxis are associated with low efficacy and/or tolerability. Monoclonal antibodies to the calcitonin gene-related peptide (CGRP) receptor, including erenumab, fremanezumab, galcanezumab and eptinezumab, have emerged as effective treatments for migraine prevention. Fremanezumab, galcanezumab and eptinezumab target the CGRP protein, while erenumab targets the canonical receptor. A growing body of clinical data supports their efficacy and safety. While long-term data are needed, these are the first preventative drugs based on the pathophysiology of migraine, and represent a major therapeutic advance.