Migraine Patients Treated With Erenumab and the Risk of Hypertension: A Registry-Based Real-World Study

Background:

Recent post-marketing studies have indicated a possible association between anti-CGRP receptor monoclonal antibodies (anti-CGRP-mAbs) used for migraine prophylaxis and an increased risk of hypertension (HT). 

Methods:

We performed a retrospective real-world exploratory study, including individuals with a confirmed diagnosis of migraine who were treated with erenumab, an anti-CGRP receptor (r)-mAb, for at least 12 months. Inclusion was limited to individuals with complete clinical records and regular follow-up, with at least one visit every 3 months and data available to assess treatment outcomes. Patients were excluded if they had previously received anti-CGRP mAbs or gepants for migraine prevention before starting the current therapy, were on any concomitant baseline migraine preventive treatment, or did not complete the 12-month follow-up visits. 

Results: 

One hundred twenty-five participants were eligible and included in the analysis. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were compared between baseline and follow-up visits, conducted every 3 months for up to 24 months while the patient was on treatment. Individuals treated with erenumab initially received 70 mg, administered subcutaneously every 4 weeks. Throughout the 12-month treatment period, blood pressure (BP) measurements remained stable and within normal physiological ranges, indicating no significant hypertensive effect. Analysis across multiple visits showed that SBP ranged from 118 to 121 mmHg, while DBP stayed between 78 and 80 mmHg. Erenumab treatment over 24 months in 54 patients demonstrated stable BP with no notable hypertensive effects.

Conclusions: 

This study did not find sufficient evidence that treatment with erenumab leads to the development of HT.