Erenumab Indication for Migraine Prevention

Primary Indications

Erenumab is indicated as a second-line therapy for the prevention of episodic migraine in nonpregnant adults who do not tolerate or inadequately respond to first-line preventive treatments, as recommended by the American College of Physicians 1, 2, 3
The American Academy of Neurology recommends Erenumab (Aimovig) as a calcitonin gene-related peptide (CGRP) monoclonal antibody approved for the preventive treatment of migraine in adults 4
Erenumab is specifically recommended as a second-line therapy after failure of first-line treatments including beta-blockers, valproate, venlafaxine, or amitriptyline, according to the American Headache Society 1, 2, 3
The American College of Physicians indicates that Erenumab is indicated for both episodic migraine and chronic migraine 4, 5

The American College of Physicians recommends beta-blockers, such as metoprolol or propranolol, as first-line preventive treatments for migraine 2
The American Academy of Neurology suggests valproate as a first-line preventive treatment, but it is contraindicated in women of childbearing potential 6
The American Headache Society recommends venlafaxine and amitriptyline as first-line preventive treatments for migraine 1, 2, 3
The American College of Physicians indicates that CGRP monoclonal antibodies, including erenumab, and CGRP antagonist-gepants are second-line treatments for migraine 1, 2, 3
Topiramate is recommended as a third-line treatment for migraine by the American Academy of Neurology 1, 2, 3

The American College of Physicians notes that erenumab may increase the risk of development or worsening of hypertension, particularly with erenumab 4
The American Academy of Neurology recommends evaluating the efficacy of erenumab after 3-6 months of treatment and monitoring for development or worsening of hypertension during treatment 6, 4
The American Headache Society suggests considering preventive treatment in patients experiencing significant disability from migraine on ≥2 days per month despite optimized acute treatment 6