2018: Migraine Prevention Advance

On This Day in Health: May 17, 2018

On May 17, 2018, the U.S. Food and Drug Administration approved erenumab, marketed as Aimovig, to prevent migraine in adults. The medicine introduced a targeted approach built around the calcitonin gene-related peptide receptor, usually shortened to CGRP receptor. Its arrival reflected years of work connecting migraine biology to a treatment designed for prevention. The decision did not mean that migraine had been cured or that an injection could end every attack. It gave patients and clinicians an additional preventive option, with a different mechanism from many medicines already being used for that purpose.

Migraine is a neurological condition whose effects extend beyond headache pain. Attacks can include nausea and sensitivity to light or sound, interrupting work, study, family responsibilities and ordinary activities. Treatment has two different jobs: helping during an attack and reducing the burden of future attacks. Preventive care can involve medicines, attention to patterns and habits, and tracking symptoms over time. A headache diary can help make that burden visible during a consultation. The distinction matters when explaining the 2018 approval, because erenumab was approved for ongoing prevention rather than as an immediate rescue treatment taken when pain began.

Erenumab is a monoclonal antibody that blocks the CGRP receptor. Studies compared monthly treatment with placebo and measured changes in the number of migraine days. The development program included people with episodic and chronic migraine, and the company reported reductions in monthly migraine days across the major studies. That measurement addressed a practical outcome: how often a person had to live through an attack. Benefits varied, and a reduction in attacks did not necessarily eliminate the need for other care. Injection-site reactions and constipation were among the common adverse reactions reported at approval. The medicine's advantages therefore had to be considered alongside its tolerability and each person's circumstances.

May 17 is a useful milestone because it links a better understanding of a disease to a new way of treating it. Migraine had long imposed a substantial burden that could be difficult for others to see. A preventive treatment developed around a relevant biological pathway helped make both the disease and the research behind it more visible. The historical importance lies in the expanded choice, rather than a promise that one medicine would suit everyone. Remembering the approval also means recognizing the clinical-trial participants whose records of attacks made the evidence possible. Their experience helped turn a laboratory target into an option that could be discussed in an ordinary consultation.