A new era for migraine patients

The European Commission (EC) has approved Novartis's Aimovig (erenumab) for the prevention of migraine in adults experiencing four or more migraine days per month. Aimovig is the first and only treatment specifically designed for migraine prevention to be approved in the European Union, Switzerland, the US and Australia. It works by blocking a receptor called the calcitonin gene-related peptide receptor (CGRP-R), which plays a critical role in mediating the incapacitating pain of migraine. In the extensive clinical program of 2,600 patients, those on Aimovig experienced significant reductions in their number of migraine days per month, with a safety and tolerability profile similar to placebo. Aimovig can be self-administered or administered by another trained person every 4 weeks with the SureClick autoinjector pen, an established device commonly used for a range of different conditions.

"Migraine matters. It is a painful, highly disruptive neurological disease that affects all aspects of life, from going to work to spending time with family and friends," said Patrick Little, President of the European Migraine and Headache Alliance. "A treatment specifically designed for migraine prevention is a much-welcomed innovation and could transform lives of patients for whom current therapies do not work or are not well tolerated."

Aimovig showed efficacy even in a difficult-to-treat population. It is the only CGRP-R pathway therapy specifically studied in patients who had failed on two to four previous treatments commonly used for migraine prevention. Furthermore, in an interim analysis from a 5-year open-label extension (OLE) in episodic migraine, it was demonstrated that 26% of patients taking Aimovig 70 mg, who were still enrolled and assessed for migraine over month fifteen, were completely migraine free.

"Erenumab heralds a new era in clinical practice, bringing both a targeted mechanism for prevention and a deep understanding of migraine, which we have never had before," said Peter Goadsby, Director, NIHR-Wellcome Trust King's Clinical Research Facility and Professor of Neurology at King's College London. "We will see sustained relief from migraine for many of those who suffer with this debilitating disease."

"This approval is groundbreaking for people living with migraine, their families and doctors," said Paul Hudson, CEO Novartis Pharmaceuticals. "In clinical trials, Aimovig has consistently shown to be effective in preventing migraine and bringing relief from the grip of this disease. We are proud to be the first to reimagine migraine prevention and we are committed to ensuring Aimovig's availability for those who could benefit from it. We are launching a tailored post-approval access program and are exploring a number of innovative reimbursement and access approaches, including paying only for patients who respond well to treatment."

A post-approval access program has been opened to provide Aimovig in countries where the local regulations allow provision of unapproved or yet to be reimbursed therapies. Support programs are also being developed for eligible patients in line with local regulations that include personalized services, information and resources to support them as they begin their treatment with Aimovig.

The EMA decision is applicable to all 28 European Union member states plus Iceland, Norway and Liechtenstein. Aimovig (erenumab-aooe) received FDA approval for the preventive treatment of migraine in adults on 17 May 2018. Aimovig received Swissmedic approval in Switzerland on 13 July 2018 and Australian TGA registration on 3 July 2018. Additional regulatory filings are underway with other health authorities worldwide.

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