EAN 2026 | Erenumab outperforms OnabotulinumtoxinA in migraine prevention

Yeah, as we all know, migraine is one of the most debilitating disorders and we have a lot of preventive medications and the latest one is erenumab and we have been using onabotulinum toxin A for a long time but there is no real-world data comparing the effectiveness of both erenumab and onabotulinum toxin. So what we planned to do was to have a real-world evidence to find the effectiveness. So we did a trial called a targeted trial emulation, which is a latest epidemiological study, which we can find using real-world data. Because it’s very hard to do a randomized controlled trial with so much population. So we did a targeted trial emulation and it showed erenumab outperformed onabotulinum toxin in all aspects. So our main outcome was reducing triptan dosage. In clinical context, reducing triptan dosage is reducing the monthly migraine days. So what we found is there is a reduction of monthly migraine days or triptan dosage up to eight difference between erenumab and onabotulinum toxinA migraine days. So it’s a substantial amount of decrease. And the secondary outcome was 50% reduction in the monthly migraine days or the dispensed triptan usage. So what we found is about 10% difference between erenumab and onabotulinum toxin. So we can put an end to the discussion that erenumab outperforms onabotulinum toxin in all aspects. So this has been a question. The clinicians knew about it, but there was not any hard evidence. So now we can find this evidence.

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