Data presented by Fred Cohen, MD, internal medicine resident physician, department of medicine, Montefiore Health System, at the American Headache Society (AHS) Virtual Annual Scientific Meeting on June 13, 2020, suggest that patients with chronic migraine receiving treatment with onabotulinumtoxinA (Botox) who require additional preventive treatment can be given calcitonin gene-related peptide (CGRP) monoclonal antibody medications safely and effectively.

Ultimately, in a cohort of 153 patients treated with onabotulinumtoxinA, 66 continued to have 14.3 monthly headache days despite significant reductions from baseline headache days prior to treatment with onabotulinumtoxinA (baseline, 25.3 days; reduction, 10.9 days [43%]; P .0001). The add-on of a CGRP therapy was associated with an additional decrease of 5.6 days, equating to an additional 22.3% reduction (95% CI, 4.5–6.7; P .0001) in monthly headache days. Of the 153-patient study population, 88 (58%) were treated with erenumab (Aimvoig; Novartis), 51 (33%) were treated with galcanezumab (Emgality; Eli Lilly), and 14 (9%) were treated with fremanezumab (Ajovy; Teva).

To find out more about what prompted the study, what the population looked like, and how these data can be interpreted, NeurologyLive spoke with Cohen in an interview. He offered insight into the study’s reasoning as well as what research still needs to be done to analyze the combination use of these medicines.

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