@article {Ferrari254, author = {Michel Dominique Ferrari and Uwe Reuter and Peter J Goadsby and Gabriel Paiva da Silva Lima and Subhayan Mondal and Shihua Wen and Nadia Tenenbaum and Shaloo Pandhi and Michel Lanteri-Minet and Tracy Stites}, title = {Two-year efficacy and safety of erenumab in participants with episodic migraine and 2{\textendash}4 prior preventive treatment failures: results from the LIBERTY study}, volume = {93}, number = {3}, pages = {254--262}, year = {2022}, doi = {10.1136/jnnp-2021-327480}, publisher = {BMJ Publishing Group Ltd}, abstract = {Objective To evaluate individual and group long-term efficacy and safety of erenumab in individuals with episodic migraine (EM) for whom 2{\textendash}4 prior preventatives had failed.Methods Participants completing the 12-week double-blind treatment phase (DBTP) of the LIBERTY study could continue into an open-label extension phase (OLEP) receiving erenumab 140 mg monthly for up to 3 years. Main outcomes assessed at week 112 were: >=50\%, >=75\% and 100\% reduction in monthly migraine days (MMD) as group responder rate and individual responder rates, MMD change from baseline, safety and tolerability.Results Overall 240/246 (97.6\%) entered the OLEP (118 continuing erenumab, 122 switching from placebo). In total 181/240 (75.4\%) reached 112 weeks, 24.6\% discontinued, mainly due to lack of efficacy (44.0\%), participant decision (37.0\%) and adverse events (AEs; 12.0\%). The >=50\% responder rate was 57.2\% (99/173) at 112 weeks. Of >=50\% responders at the end of the DBTP, 36/52 (69.2\%) remained responders at >=50\% and 22/52 (42.3\%) at \>80\% of visits. Of the non-responders at the end of the DBTP, 60/185 (32.4\%) converted to >=50\% responders in at least half the visits and 24/185 (13.0\%) converted to >=50\% responders in \>80\% of visits. Change from baseline at 112 weeks in mean (SD) MMD was -4.2 (5.0) days. Common AEs (>=10\%) were nasopharyngitis, influenza and back pain.Conclusions Efficacy was sustained over 112 weeks in individuals with difficult-to-treat EM for whom 2{\textendash}4 prior migraine preventives had failed. Erenumab treatment was safe and well tolerated, in-line with previous studies.Trial registration number NCT03096834 Data are available on reasonable request. The study data for the analysis described in this report may be made available on request from the author investigators or Novartis Pharma AG, sponsor of this clinical research.}, issn = {0022-3050}, URL = {https://jnnp.bmj.com/content/93/3/254}, eprint = {https://jnnp.bmj.com/content/93/3/254.full.pdf}, journal = {Journal of Neurology, Neurosurgery \& Psychiatry} }