Aimovig after Concussion?

Now that several CGRP related medications are on the market for migraine, researchers are interested in finding other uses for the same drugs (even to fight COVID-19). One case in point is the use of Aimovig (erenumab) for headache from a hit in the head.

There are a series of different types of headache that are due to head or neck trauma. Under the heading of “Acute headache attributed to traumatic injury to the head“, the International Classification of Headache Disorders 3 points out that the common definition is a headache that starts within 7 days of the injury, although this is “somewhat arbitrary”, because there is some evidence that the headache could start up to three months later. The problem is that, the longer the interval, the harder it is to connect the headache with the injury.

Millions and millions of head injuries happen every year, so this is a very common issue. A concussion is really a type of brain injury, and there is still a lot that we don’t know about how concussions affect the body (although we’ve learned a lot in the past 20 years).

So from this small initial study, how did Aimovig measure up when it comes to post-traumatic headache (due to mild traumatic brain injury, or concussion)?

It should be noted that these patients were all women, and had suffered from their headaches for over a year (to several years). They had also already tried at least one other daily preventative for headache. So this is not a case of someone with a bit of a headache a couple of weeks after a fall – these are ongoing, difficult cases. And the headaches were moderate to severe.

Taking erenumab, the patients found that, on average, the pain decreased by about half. All five patients were able to stop taking at least one other medication. Four out of five patients continued taking erenumab after the study was completed. But even better, patient #5 stopped taking it because their headaches disappeared completely.

There were no serious side effects, though three patients did have some constipation.

It’s a small study, but for challenging headaches like these the results look good. It may be that other CGRP receptor blockers will also have a wider application for headache treatment.

For more, read the study abstract here: Use of CGRP receptor blocker erenumab in the management of post-traumatic headache: a case series of 5 women