First And Only Randomized, Double-blind, Head-to-head Study Comparing Aimovig® , An Anti-CGRP Pathway Therapy, To Topiramate Published In Cephalalgia

Amgen (NASDAQ:AMGN) today announced new data from the HER-MES study, the first and only head-to-head study of Aimovig ® (erenumab-aooe), a calcitonin gene-related peptide (CGRP) inhibitor, against topiramate for adult patients with episodic and chronic migraine. Topiramate is one of the most commonly prescribed medications in migraine prevention with an estimated 600,000 new-to-brand prescriptions written in the U.S. each year. 1,2 Published in Cephalalgia, the results of the study conducted by Novartis showed that patients in the Aimovig treatment arm experienced a significantly lower discontinuation rate due to adverse events and superior efficacy, with a greater proportion of patients achieving at least a 50 percent reduction from baseline in their monthly migraine days (MMDs), compared with topiramate. 3

"HER-MES is the first study that directly compared the therapeutic effects of an antibody and a small molecule in migraine prevention," said Uwe Reuter , M.D., Ph.D., MBA, trial investigator and managing medical director at Charité Universitätsmedizin in Berlin . "The positive outcomes strengthen the efficacy and safety profile of erenumab as a migraine prevention treatment for patients with migraine."

In this head-to-head Phase IV study, patients in the Aimovig arm demonstrated a significantly lower discontinuation rate due to adverse events versus patients in the topiramate arm (10.6% versus 38.9%). Additionally, significantly more patients in the Aimovig arm achieved at least a 50% reduction from baseline in their MMDs than those in the topiramate group (55.4% versus 31.2%). In the topiramate group, the most frequent adverse events that led to discontinuation of the study medication were paraesthesia, disturbance in attention, fatigue, and nausea. In the Aimovig group, these were fatigue, nausea, disturbance in attention and dizziness. Additional study treatment-related adverse events reported by ≥2% in any trial group included constipation, decreased appetite, taste disorder, vertigo, dysgeusia, weight loss, dry mouth, irritability, mood swings, diarrhea, depression, sleep disorder, depressed mood, hypoesthesia, upper abdominal pain, aphasia, insomnia, memory impairment, dyspepsia, dysesthesia and headache. ³

"We're extremely encouraged by these new results, which demonstrate lower discontinuation rates due to adverse events and superior efficacy versus topiramate in migraine prevention and strengthen our confidence that Aimovig has significant potential to help many more patients living with migraine," said Rob Lenz , M.D., Ph.D., senior vice president of Global Development at Amgen. "Amgen is dedicated to helping the millions of people who live with this debilitating neurological disease get back to what's important to them while living with more migraine-free days."

Migraine is a highly debilitating disease that has a significant impact on people's lives, including time spent with family and friends, or at work. ^4,5 Aimovig is the first FDA-approved migraine preventive treatment that targets the CGRP receptor. ⁶ It is self-administered once monthly subcutaneously via the SureClick ^® autoinjector, does not require a loading dose and is easy to use. ^6,7

About HER-MES  
HER-MES (NCT03828539) is the first randomized, double-blind, double-dummy, active-controlled, parallel-group Phase IV study to assess tolerability (as assessed by the discontinuation rates due to adverse events) and efficacy of Aimovig versus topiramate in a patient-centered setting. ³ The primary endpoint was treatment discontinuation rate due to adverse events of 70 mg and 140 mg Aimovig monthly compared with 50 to 100 mg topiramate daily during the double-blind treatment phase of the study. ³ The secondary endpoint was efficacy of 70 mg and 140 mg Aimovig monthly versus 50 to 100 mg topiramate daily in terms of at least a 50% reduction in monthly migraine days from baseline in the last three months (months 4, 5 and 6) of the double-blind, 24-week treatment phase. ³ The HER-MES study enrolled 777 adult patients with episodic or chronic migraine (≥4 migraine days per month) who had not previously received migraine prevention treatment or had failed up to three previous therapies with propranolol/metoprolol, amitriptyline and/or flunarizine. ³ After the 2-week screening and 4-week baseline phase, patients received either Aimovig subcutaneously and topiramate placebo orally or topiramate orally and Aimovig placebo subcutaneously. In the double-blind, 24-week treatment phase, patients in the Aimovig arm received either 70 mg or 140 mg directly after the baseline phase, as estimated by the investigator. ³ An increase in dose from 70 mg to 140 mg was possible at any time during the study. Patients in the topiramate arm were given topiramate at the highest tolerated dose (50-100 mg daily), starting with a 6-week titration phase. ³ The study was conducted by Novartis at 82 study sites in Germany between February 2019 and July 2020 .

About   Aimovig ^® (erenumab-aooe)  
Aimovig is the first FDA-approved migraine preventive treatment that targets the calcitonin gene-related peptide (CGRP) receptor, which is associated with migraine. ⁶ Aimovig has been studied in several large, global, randomized, double-blind, placebo-controlled studies to assess its efficacy and safety in migraine prevention. ^8,9 Aimovig is self-administered once monthly via the easy-to-use SureClick ^® autoinjector, without a required loading dose. ^6,7 More than 3,000 patients participated in registrational trials of Aimovig across four placebo-controlled Phase 2 and Phase 3 clinical studies and their open-label extensions. ^8-13

Aimovig is also being evaluated through CATALYST, a comprehensive evidence generation program initiated by Amgen and Novartis that includes over 7,500 patients across ongoing clinical trials and a robust assessment of real-world evidence. Spanning over 39 countries globally, CATALYST clinical trials will explore the role of Aimovig in comparative studies, assessing impact on novel migraine outcomes, understanding predictive biomarkers and investigating Aimovig's use in additional study populations. To date, more than 500,000 patients in the United States have been prescribed Aimovig for the preventive treatment of migraine in adults. ¹⁴

AIMOVIG INDICATION  
Aimovig ^® (erenumab-aooe) is indicated for the preventive treatment of migraine in adults.

IMPORTANT SAFETY INFORMATION  
Contraindication: Aimovig ^® is contraindicated in patients with serious hypersensitivity to erenumab-aooe or to any of the excipients. Reactions have included anaphylaxis and angioedema.

Hypersensitivity Reactions : Hypersensitivity reactions, including rash, angioedema, and anaphylaxis, have been reported with Aimovig ^® in postmarketing experience. Most reactions were not serious and occurred within hours of administration, although some occurred more than one week after administration. If a serious or severe reaction occurs, discontinue Aimovig ^® and initiate appropriate therapy.

Constipation with Serious Complications : Constipation with serious complications has been reported following the use of Aimovig ^® in the postmarketing setting. There were cases that required hospitalization, including cases where surgery was necessary. The onset of constipation was reported after the first dose in a majority of these cases, but patients also reported later on in treatment. Aimovig ^® was discontinued in most reported cases. Constipation was one of the most common (up to 3%) adverse reactions reported in clinical studies.

Monitor patients treated with Aimovig ^® for severe constipation and manage as clinically appropriate. Concurrent use of medications associated with decreased gastrointestinal motility may increase the risk for more severe constipation and the potential for constipation-related complications.

Hypertension: Development of hypertension and worsening of pre-existing hypertension have been reported following the use of Aimovig ^® in the postmarketing setting. Many of the patients had pre-existing hypertension or risk factors for hypertension. There were cases requiring pharmacological treatment and, in some cases, hospitalization. Hypertension may occur at any time during treatment but was most frequently reported within seven days of dose administration. In the majority of the cases, the onset or worsening of hypertension was reported after the first dose. Aimovig ^® was discontinued in many of the reported cases.

Monitor patients treated with Aimovig ^® for new-onset hypertension, or worsening of pre-existing hypertension, and consider whether discontinuation of Aimovig ^® is warranted if evaluation fails to establish an alternative etiology.

Adverse Reactions : The most common adverse reactions in clinical studies (≥ 3% of Aimovig ^® -treated patients and more often than placebo) were injection site reactions and constipation.

Please see Aimovig ^® full Prescribing Information .

About Migraine  
People with frequent migraine attacks may lose more than half their life to migraine. ^17,16 They endure debilitating pain, physical impairment, and can live in constant dread of the next attack – all of which is compounded by a widespread misperception of the disease. ^5,17 The 2019 Global Burden of Disease Study ranks migraine among the top 10 causes of years lived with disability worldwide. ¹⁸ Migraine is associated with personal and societal burdens of pain, disability and financial cost, and it remains under-recognized and under-treated. ^5,19

About Amgen   
Amgen is committed to unlocking the potential of biology for patients suffering from serious illnesses by discovering, developing, manufacturing and delivering innovative human therapeutics. This approach begins by using tools like advanced human genetics to unravel the complexities of disease and understand the fundamentals of human biology.

Amgen focuses on areas of high unmet medical need and leverages its expertise to strive for solutions that improve health outcomes and dramatically improve people's lives. A biotechnology pioneer since 1980, Amgen has grown to be one of the world's leading independent biotechnology companies, has reached millions of patients around the world and is developing a pipeline of medicines with breakaway potential.

For more information, visit www.amgen.com and follow us on www.twitter.com/amgen .

Amgen Forward-Looking Statements  
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References

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2. Data on File. Amgen. September 2021
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