Erenumab and
OnabotulinumtoxinA
in Chronic Migraine: A Comparative Analysis
María Garcés‐Pellejero, Marta Torres‐Ferrús, Rut Mas‐de‐les‐Valls, Edoardo Caronna, Alicia Alpuente, Eulalia Giné‐Ciprés, Patricia Pozo‐Rosich ABSTRACT
Objectives
To compare response (reduction in headache frequency and differences in patient‐reported outcomes) between Erenumab and OnabotulinumtoxinA from two phase‐IV trials after 6 months of treatment.
Materials/Methods
A prospective cohort study included two parallel cohorts of chronic migraine patients treated with either Erenumab 140 mg/month or OnabotulinumtoxinA 195 U every 3 months. Participants had no additional preventive therapies or comorbid psychiatric or chronic pain conditions. Baseline data collected included demographics, monthly headache (MHD) and migraine days (MMD), impact scales (MIDAS, HIT‐6, MSQ), and anxiety/depression scores (BAI, BDI‐II). Assessments were repeated at 6 months. Baseline characteristics were balanced. Efficacy analysis (measured by reduction in MHD/MMD and impact scales) was conducted using paired t ‐test, and linear regression models compared treatment‐related changes between groups.
Results
A total of 114 patients were analyzed (57 per group), with no significant baseline differences. Both treatments produced significant reductions in headache frequency at 6 months (Erenumab: −7.93 MHD and −5.36 MMD, p < 0.001; OnabotA: −6.00 MHD and −4.31 MMD, p < 0.001), without statistically significant differences between therapies. Significant improvements were observed in HIT‐6 and MSQ scores in both cohorts ( p < 0.05). The Erenumab group showed significant reductions in MIDAS, BDI, and BAI scores ( p < 0.05). Differences between treatments were significant for MIDAS improvements at three and 6 months ( p < 0.05).
Conclusion
Erenumab and OnabotulinumtoxinA are effective preventive treatments for chronic migraine. No significant differences were found in the magnitude of headache reduction at 3 or 6 months when comparing both treatments.