Anti-CGRP Antibody Erenumab Cuts Migraine Days in Half and Improves Family Life Over 2 Years

What the researchers found

Over 24 months of erenumab treatment in 173 patients (84.9% female, mean age 44.2, 45.7% chronic migraine), significant improvements were observed across all measures (all p < 0.001):

- Monthly migraine days: decreased by 8.8 ± 7.6 (from 16.5 baseline)

- HIT-6 headache impact: decreased by 8.1 ± 8.6 (from 65.9 baseline)

- mMIDAS disability: decreased by 16.6 ± 21.2

- Monthly acute medication days: decreased by 5.2 ± 6.8 (from 11.5 baseline)

- IMPAC family burden: decreased by 6.5 ± 6.6

48.6% had at least one adverse event, 35.3% had drug-related adverse events, but no serious adverse events were attributed to erenumab.

Why it matters

While clinical trials showed erenumab's efficacy in controlled settings, real-world evidence over 2 years is crucial for confirming sustained benefit in routine clinical practice. This study uniquely measured family impact, showing that CGRP-targeting therapy improves not just patients' lives but their families' lives too — an outcome rarely captured in migraine trials.

How the study worked

Prospective, multicenter, noninterventional cohort study across 19 Swiss sites enrolling adults with episodic or chronic migraine who received erenumab per Swiss label from February 2019 to November 2022. Data collected over 24 months included patient-reported outcomes (HIT-6, mMIDAS, IMPAC questionnaires), migraine diaries (required 3 months before and during treatment), and medical chart data on medication use and healthcare utilization.

What this study cannot tell us

This is an observational cohort study without a control group, so placebo effects and natural disease fluctuation cannot be excluded. The 173-patient sample is moderate in size. The 2-year completion rate is not specified, introducing potential survivorship bias (patients who continued may be those who responded best). The Swiss healthcare context (mandated diary-keeping, label restrictions) may limit generalizability to other countries.

How to read the evidence

This is a prospective, multicenter, noninterventional cohort study (real-world evidence). While it lacks a control group, the prospective design, 2-year follow-up, 19-site scope, and multiple validated outcome measures provide high-quality observational evidence that complements the existing RCT data for erenumab.

When this study was published

Published in 2025 with data collected 2019-2022, this is among the longest real-world follow-up studies for anti-CGRP therapy in migraine.

The bigger picture

This study contributes to the growing body of real-world evidence supporting anti-CGRP antibodies as a sustained, effective migraine treatment. The family burden data is particularly noteworthy — migraine is often viewed as an individual condition, but its impact extends to partners and children. Documenting these broader benefits strengthens the case for widespread access to CGRP-targeting peptide therapies.

Questions still open

• Does the family burden improvement from erenumab translate into measurable economic benefits (reduced caregiver burden, fewer missed school/work days)?
• How do patients who stop erenumab after 2 years fare — does migraine return to baseline?
• Would earlier initiation of anti-CGRP therapy produce even greater quality of life improvements?

Common questions

Read the original research

Swiss Quality of Life and Health Care Impact Assessment in a Real-World Erenumab-Treated Migraine Population: Results over 2 years.

Headache, 65(7), 1134-1147

Citation

Gantenbein, Andreas R; Kamm, Christian P; Schankin, Christoph J; Zecca, Chiara; Zieglgänsberger, Dominik; Pohl, Heiko; Ryvlin, Philippe; Agosti, Reto; Viceic, Dragana; Parzini, Catherine; Kulartz-Schank, Monika; Arzt, Michael E. (2025). Swiss Quality of Life and Health Care Impact Assessment in a Real-World Erenumab-Treated Migraine Population: Results over 2 years.. Headache, 65(7), 1134-1147. https://doi.org/10.1111/head.14943