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[Comment] A new opportunity after migraine treatment failure?

Failure of migraine preventive therapy because of poor efficacy or tolerability is an all too common problem in clinical practice. Patients are frequently dissatisfied with available preventive treatments and compliance is poor.1 The 12-week, randomised, double-blind, placebo-controlled, phase 3b study reported in The Lancet by Uwe Reuter and colleagues2 addresses this important issue. Reuter and colleagues examine the efficacy of erenumab 140 mg (via two 70 mg injections), a monoclonal antibody targeting CGRP, compared with placebo in a population of patients aged 18–65 years who had a history of episodic migraine with or without aura for at least 12 months, had migraine symptoms for an average of 4–14 days per month during the 3 months before screening, and who had previously been treated unsuccessfully with between two and four preventive treatments.