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Erenumab

Phase 2

Stable Angina | Small molecule | Cardiovascular |Amgen Inc.|Last Updated: Oct 12, 2022

Target and mechanism

Molecular targetCALCRL
Target classAntagonist
ModalitySmall molecule

Also known as Erenumab Dose 1

Success Probability

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Market & Valuation

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Trial Design

RandomizedDouble-BlindPLACEBO_CONTROLLEDDMC
Total Trials1
Total Enrollment89

FDA Designations

No designations recorded

Clinical trial landscape

Erenumab · 5 trials · 4 indications

Phase 2 3Phase 1 2
NCT02575833Treadmill Cardiovascular Safety Study of Erenumab (AMG 334)Stable Angina
COMPLETED89 Analytics
NCT02174861A Study to Assess the Long-term Safety and Efficacy of Erenumab (AMG 334) in Chronic Migraine Prevention.Treatment for Prevention of Chronic Migraine
COMPLETED609 Analytics
NCT02066415A Study to Evaluate the Efficacy and Safety of Erenumab (AMG 334) in Chronic Migraine PreventionTreatment for Prevention of Chronic Migraine
COMPLETED667 Analytics
PHASE2COMPLETED
Treadmill Cardiovascular Safety Study of Erenumab (AMG 334)
Stable AnginaUnlock trial analytics
PHASE2COMPLETED
A Study to Assess the Long-term Safety and Efficacy of Erenumab (AMG 334) in Chronic Migraine Prevention.
Treatment for Prevention of Chronic MigraineUnlock trial analytics
PHASE2COMPLETED
A Study to Evaluate the Efficacy and Safety of Erenumab (AMG 334) in Chronic Migraine Prevention
Treatment for Prevention of Chronic MigraineUnlock trial analytics

Study Endpoints

Primary Endpoints

Change From Baseline in Total Exercise Time
Baseline and day 1, after dosing

Total exercise time was assessed using an exercise treadmill test according to the standard Bruce protocol. The Bruce protocol is a standardized multistage treadmill test for assessing cardiovascular health, where the participant walks on an uphill treadmill in a graded exercise test with electrodes on the chest to monitor cardiac function. Every 3 minutes, the speed and incline of the treadmill are increased. There are 7 such stages for a total possible exercise time of 21 minutes.

Number of Participants With Adverse Events
From first dose of erenumab in extension study 20130255 to the end of the 12-week safety follow-up period (up to 64 weeks).

Adverse events (AEs) were graded for severity using the Common Terminology Criteria for Adverse Events (CTCAE) version 4.03, where Grade 1 = mild AE, asymptomatic or mild symptoms; Grade 2 = Moderate AE; Grade 3 = Severe or medically significant but not immediately life-threatening; Grade 4 = Life-threatening consequences; urgent intervention indicated; Grade 5 = Death related to AE.

CHU Substudy: Number of Participants Able to Administer a Full Dose of Erenumab in Home-use
Day 29 (week 4) and day 57 (week 8) of the substudy

At the CHU substudy day 28 and day 56 visits, the site provided erenumab 140 mg to participants to self-administer at home on the following day. Study site staff then called the participants and asked if they administered a full, partial, or no dose of erenumab. A full dose was defined when the entire volume of both prefilled syringes or autoinjector/pens were injected.

Change From Baseline in Monthly Migraine Days
4-week baseline phase and the last 4 weeks of the 12-week treatment phase

A migraine day was any calendar day in which the participant experienced a qualified migraine headache (onset, continuation, or recurrence of the migraine headache). A qualified migraine headache was defined either as a migraine with or without aura. The change from baseline in monthly migraine days was calculated as the number of migraine days during the last 4 weeks of the 12-week treatment phase - the number of migraine days during the 4-week baseline phase.

Maximum Observed Plasma Concentration (Cmax) of Ethinyl Estradiol
Cycle 2, day 21 and cycle 3, day 21 at predose and 0.5, 1, 1.5, 2, 3, 4, 5, 6, 8, 12, 16, and 24 hours post oral contraceptive dose.

The pharmacokinetics of ethinyl estradiol (EE) were characterized during cycle 2 following the last active dose of oral contraceptive in the cycle (cycle day 21) without erenumab, and during cycle 3 following the last active dose of oral contraceptive in the cycle (cycle day 21), 11 days after a single dose of erenumab.

Area Under the Plasma Concentration Time Curve From Time 0 to 24 Hours Postdose (AUCtau) for Ethinyl Estradiol
Cycle 2, day 21 and cycle 3, day 21 at predose and 0.5, 1, 1.5, 2, 3, 4, 5, 6, 8, 12, 16, and 24 hours post oral contraceptive dose.

The pharmacokinetics of ethinyl estradiol (EE) were characterized during cycle 2 following the last active dose of oral contraceptive in the cycle (cycle day 21) without erenumab, and during cycle 3 following the last active dose of oral contraceptive in the cycle (cycle day 21), 11 days after a single dose of erenumab.

Maximum Observed Plasma Concentration (Cmax) of Norgestrel
Cycle 2, day 21 and cycle 3, day 21 at predose and 0.5, 1, 1.5, 2, 3, 4, 5, 6, 8, 12, 16, and 24 hours post oral contraceptive dose.

The pharmacokinetics of norgestrel (NG), an active metabolite of norgestimate, were characterized during cycle 2 following the last active dose of oral contraceptive in the cycle (cycle day 21) without erenumab, and during cycle 3 following the last active dose of oral contraceptive in the cycle (cycle day 21), 11 days after a single dose of erenumab.

Area Under the Plasma Concentration Time Curve From Time 0 to 24 Hours Postdose (AUCtau) for Norgestrel
Cycle 2, day 21 and cycle 3, day 21 at predose and 0.5, 1, 1.5, 2, 3, 4, 5, 6, 8, 12, 16, and 24 hours post oral contraceptive dose.

The pharmacokinetics of norgestrel (NG), an active metabolite of norgestimate, were characterized during cycle 2 following the last active dose of oral contraceptive in the cycle (cycle day 21) without erenumab, and during cycle 3 following the last active dose of oral contraceptive in the cycle (cycle day 21), 11 days after a single dose of erenumab.

Maximum Observed Plasma Concentration (Cmax) of Norelgestromin
Cycle 2, day 21 and cycle 3, day 21 at predose and 0.5, 1, 1.5, 2, 3, 4, 5, 6, 8, 12, 16, and 24 hours post oral contraceptive dose.

The pharmacokinetics of norelgestromin (NGMN), an active metabolite of norgestimate, were characterized during cycle 2 following the last active dose of oral contraceptive in the cycle (cycle day 21) without erenumab, and during cycle 3 following the last active dose of oral contraceptive in the cycle (cycle day 21), 11 days after a single dose of erenumab.

Area Under the Plasma Concentration Time Curve From Time 0 to 24 Hours Postdose (AUCtau) for Norelgestromin
Cycle 2, day 21 and cycle 3, day 21 at predose and 0.5, 1, 1.5, 2, 3, 4, 5, 6, 8, 12, 16, and 24 hours post oral contraceptive dose.

The pharmacokinetics of norelgestromin (NGMN), an active metabolite of norgestimate, were characterized during cycle 2 following the last active dose of oral contraceptive in the cycle (cycle day 21) without erenumab, and during cycle 3 following the last active dose of oral contraceptive in the cycle (cycle day 21), 11 days after a single dose of erenumab.

Ratio of Week 4 to Baseline Average Number of Daily Moderate to Severe Hot Flashes
Baseline (days -7 to day 1 predose) and week 4 (days 21 to 27)

The severity of hot flashes was assessed by participants based on the following categories: * Mild: sensation of heat without sweating, mild flushing; * Moderate: sensation of heat, face flushed, slightly clammy, some sweating, able to continue activity, may want to remove layers of clothing or covers at night; * Severe: sensation of heat with more severe sweating, have to stop current activity, may have to change clothing. Baseline (BL) number of hot flashes is the average number of moderate or severe hot flashes per 24 hours from day -7 to day 1 predose based on geometric mean, and the week 4 number of hot flashes is the average number of moderate or severe hot flashes per 24 hours from day 21 to day 27 based on geometric mean. The ratio of week 4 to BL was used to assess change from BL to week 4 via a log transformation (log\[week4/BL\] = log\[week4\] - log\[BL\]), which was estimated using a repeated measures analysis. The ratio was obtained via an exponential back-transformation.

Secondary Endpoints

Time to Onset of Exercise-induced Angina
Day 1
Time to Onset of ≥ 1 mm ST-segment Depression
Day 1
Change From Study 20120295 Baseline in Monthly Migraine Days
4-week baseline phase of Study 20120295 and the 4 weeks prior to the week 4, 8, 12, 24, 40, and 52 visits of Study 20130255
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Study Design & Arms

AllocationRANDOMIZED
MaskingQUADRUPLE
ModelPARALLEL
PurposeTREATMENT

Treatment Arms

ArmTypeDescription
PlaceboPLACEBO_COMPARATORParticipants received a single dose of placebo administered by intravenous infusion on day 1.
ErenumabEXPERIMENTALParticipants received a single dose of erenumab 140 mg administered by intravenous infusion on day 1.
Erenumab 70 mgEXPERIMENTALParticipants received 70 mg erenumab on day 1 and at weeks 4 and 8 by subcutaneous injection.
Erenumab 140 mgPLACEBO_COMPARATORParticipants received 140 mg erenumab on day 1 and at weeks 4 and 8 by subcutaneous injection.
Erenumab + Estrogen/Progestin ContraceptiveEXPERIMENTALParticipants received a combination oral contraceptive for 3 28-day cycles during the study. A single 140 mg dose of erenumab was administered subcutaneously to the abdomen on day 10 of cycle 3 by a healthcare provider.

Interventions

NameTypeDescription
ErenumabDRUGA single dose of erenumab 140 mg infused over approximately 60 minutes.
PlaceboDRUGA single dose of a matching volume of placebo infused over approximately 60 minutes.
Ethynil Estradiol/Norgestimate Oral ContraceptiveDRUGEthynil estradiol (EE)/norgestimate combination oral contraceptive is a 28-tablet cycle in which 1 oral tablet is taken daily; each containing 0.250 mg norgestimate and 0.035 mg EE for 21 days, after which a tablet only containing inert ingredients is taken for last 7 days of the 28 day cycle.
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Eligibility Criteria

Age Range18 Years to 85 Years
SexALL
Healthy VolunteersNo
Study Sites33

Inclusion Criteria * History of chronic stable angina or at least 3 months prior to screening, with at least 1 angina episode per month * Ischemic heart disease documented by myocardial infarction, coronary angiography or a revascularization procedure * Receiving stable doses of cardiac medication ...

Countries:United StatesBulgariaCzechiaLatviaNew ZealandPolandRomaniaSlovakiaSouth AfricaSwitzerlandCanadaDenmarkFinlandGermanyNorwaySwedenUnited Kingdom
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Frequently asked questions about Erenumab

What is Erenumab used for?

Erenumab is an investigational drug being studied for the treatment and prevention of chronic migraine, as well as for headache, vasomotor symptoms such as hot flashes, and stable angina. It is in clinical development for these conditions, with trials conducted in migraine patients and other populations.

What does Erenumab target?

Erenumab is a monoclonal antibody, indicated by its -mab suffix, and is being developed as a small molecule therapy. Its specific molecular target has not been disclosed in available clinical trial information, so its exact mechanism of action is not described here.

Who makes Erenumab?

Erenumab is developed by Amgen Inc., a biopharmaceutical company traded on NASDAQ under the ticker AMGN. Amgen is conducting clinical trials to evaluate the drug's safety and efficacy across multiple indications.

What phase is Erenumab in?

Erenumab is in Phase 1 clinical development, with early-stage trials completed in healthy adults and migraine patients. A Phase 3 trial in pediatric participants with episodic migraine is also active but not recruiting, indicating ongoing investigation across different stages.

What clinical trials is Erenumab in?

Erenumab has been studied in several clinical trials, including NCT01688739 and NCT01723514, which evaluated ascending single and multiple doses in healthy adults and migraine patients. NCT01890109 studied the drug in women with hot flashes, and NCT03836040 is a Phase 3 trial in pediatric migraine patients.

Is Erenumab the same as Erenumab Dose 1?

Yes, Erenumab is also known as Erenumab Dose 1. This alternative name appears in clinical trial contexts, and both names refer to the same investigational drug being developed by Amgen for migraine and other conditions.