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Table 7 Summary of findings table for treatment with erenumab 70 mg monthly subcutaneous injection compared with no treatment for prevention of episodic migraine

From: European headache federation guideline on the use of monoclonal antibodies acting on the calcitonin gene related peptide or its receptor for migraine prevention

Outcomes Anticipated absolute effects*(95% CI) Relative effect (95% CI) № of participants (studies) Certainty of the evidence (GRADE) Comments
Risk with placebo Risk with erenumab
Reduction in migraine days follow up: 3–6 months The mean reduction in migraine days was −1.9 days The mean reduction in migraine days in the intervention group was 1.2 days fewer (1.8 fewer to 0.5 fewer) 1455 (3 RCTs) HIGH Treatment with erenumab 70 mg results in reduction in migraine days compared with placebo.
Reduction in use of acute attack medication follow up: 3–6 months The mean reduction in use of acute attack medication was −0.6 days The mean reduction in use of acute attack medication in the intervention group was 0.8 days fewer (1.3 fewer to 0.4 fewer) 1455 (3 RCTs) HIGH Treatment with erenumab 70 mg results in reduction in use of acute attack medication compared with placebo.
Improvement in functional MPFID everyday-activities follow up: 3–6 months The mean improvement in functional MPFID everyday-activities was −3.3 points The mean improvement in functional MPFID everyday-activities in the intervention group was 2.2 points lower (3.3 fewer to 1.2 fewer) 628 (1 RCT) MEDIUMa Treatment with erenumab 70 mg results in improvement in functional MPFID everyday-activities score compared with placebo.
At least 50% reduction in days of migraine follow up: 3–6 months 283 per 1000 422 per 1000 (366 to 488) RR 1.4918 (1.2925 to 1.7217) 1441 (3 RCTs) HIGH Treatment with erenumab 70 mg results in at least 50% reduction of days of migraine compared with placebo.
Serious adverse events follow up: 3–6 months 17 per 1000 17 per 1000 (8 to 37) RR 0.9992 (0.4590 to 2.1752) 1464 (3 RCTs) HIGH Treatment with erenumab 70 mg results in a small possibly unimportant effect in serious adverse events occurrence compared with placebo.
Mortality follow up: 3–6 months 0 per 1000 0 per 1000 (0 to 0) Not estimable 1464 (3 RCTs)   No deaths occurred during the double-blind treatment phase of the trial.
  1. *The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI Confidence interval, RR Risk ratio. aDowngraded once due to inconsistency
  2. GRADE Working Group grades of evidence
  3. High certainty: We are very confident that the true effect lies close to that of the estimate of the effect
  4. Moderate certainty: We are moderately confident in the effect estimate: The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different
  5. Low certainty: Our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect
  6. Very low certainty: We have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect