Myocardial infarction associated with erenumab: A case report
Justine Perino1,2, Virginie Corand3, Elise Laurent1
1Pharmacovigilance Center of Bordeaux, Department of Medical Pharmacology, University Hospital of Bordeaux, Bordeaux, France.
Pharmacotherapy
|May 27, 2022
Summary
Monoclonal antibodies targeting calcitonin gene-related peptide (CGRP) are used for migraine. A case report suggests a potential link between erenumab treatment and myocardial infarction, highlighting the need for cardiovascular risk assessment.
Area of Science:
- Neurology
- Cardiology
- Pharmacology
Background:
- Calcitonin gene-related peptide monoclonal antibodies (CGRP-mabs) represent a novel therapeutic class for refractory migraine.
- Due to their vasodilatory inhibitory effects, CGRP-mabs are typically contraindicated in patients with recent cardiovascular disease history.
Observation:
- A 57-year-old female patient with a history of coronary artery disease received erenumab for migraine prophylaxis.
- Following dose escalation, the patient experienced symptoms consistent with myocardial infarction, confirmed by elevated troponin and electrocardiogram changes.
- Cardiac MRI revealed myocardial infarction, notably without significant coronary artery abnormalities on angiography.
Findings:
- This case report documents a myocardial infarction event in a patient treated with erenumab, a CGRP-mab.
- The event occurred despite the absence of obstructive coronary artery disease, prompting further investigation into potential CGRP-mab-associated cardiovascular risks.
Implications:
- Further research is warranted to elucidate the potential association between CGRP-mab therapy and myocardial infarction risk.
- Comprehensive cardiovascular risk assessment, including risk stratification algorithms and potentially advanced imaging, is crucial for patients over 40 initiating CGRP-mab treatment, especially those with cardiovascular risk factors.
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