Erenumab (Aimovig®)

Erenumab (Aimovig®) is a monoclonal antibody treatment which is now available on the NHS as a treatment option for preventing migraine in people who have four or more migraine days a month and have tried at least three other preventative medications that have not worked.

Erenumab is given once a month as a 140mg subcutaneous injection, which can be self-administered by the patient or by a carer. Information for patients, including a video demo and FAQs, are available on the manufacturer’s website on www.aimovig.com/start/aimovig-injection 

The injection can be administered into the abdomen, thigh or into the outer area of the upper arm (the arm should be used only if the injection is being given by a person other than the patient). Injection sites should be rotated, and injections should not be given into areas where the skin is tender, bruised, red or hard.

Erenumab must be stored in a refrigerator (2°C - 8°C); after removal from the refrigerator, it must be used within 14 days when stored at room temperature (up to 25°C) or discarded. If it is stored at a higher temperature or for a longer period it must be discarded.

To avoid discomfort at the site of injection, the pre-filled pen should be left to stand at room temperature (up to 25°C) for at least 30 minutes before injecting. It should also be protected from direct sunlight. The entire contents of the pre-filled pen must be injected. Each pre-filled pen is for single use only and designed to deliver the entire contents with no residual content remaining.

Erenumab is generally well tolerated but it may cause side effects including pain, redness or swelling at the injection site, and constipation.

It is a mandatory requirement that patients starting treatment are lifestyle compliant and keep headache diaries in the format recommended by The Walton Centre; templates are available to download and print.

The diaries will be reviewed after around 12 weeks of treatment to assess response. NICE advises that treatment is stopped at that point if it has not been sufficiently effective. When treatment is continued it will be re-evaluated regularly, and patients are instructed to bring their filled diaries (with all headache days and scores added up) to every hospital appointment.

Erenumab is not recommended in patients who are pregnant, breast feeding, are allergic to Latex or have major cardiovascular disease. Please let the medical team know if any of these apply to you.

Erenumab prescription management
To make it more convenient for patients, a third party company (Healthnet Homecare) will deliver your injections directly to your home address or preferred location. Initially, the delivery will be each month and then every three months after your 12-week review. This service is funded by Novartis (manufacturers of erenumab).
Please note that this homecare service arrangement is mandatory and you consenting to start erenumab means you have agreed for your details to be shared with Healthnet Homecare, which is external to the NHS, to process the delivery of your medication.

Frequently Asked Questions
Q1. Who will be prescribing my erenumab injections?

Your clinical team at The Walton Centre will be responsible for prescribing your erenumab injections for the duration of your treatment. However, your prescriptions will be managed by a homecare company called Healthnet Homecare. Your initial prescription will be for a 12-week supply and then if you have responded well, a follow-up prescription for 52 weeks will be written by your consultant.

Q2. When can I start my erenumab treatment once it has all been agreed with my clinical team?
It takes on average about four weeks from completing the prescription to receiving your first delivery of erenumab. However, due to service demand the waiting time can increase to around a couple of months. Once your erenumab prescription has been written by your clinical team it will be processed by the pharmacy homecare team; it will then posted to Healthnet Homecare, who will then contact you directly to arrange your account set-up.

Q3. What should I expect while waiting to start my erenumab injections?
Once Healthnet Homecare has received your prescription, they will contact you via telephone directly to register you on their systems and arrange prescription delivery. Please note they may call you on a withheld number and usually only make three attempts. Please try to answer their call when received.

Q4. Who will be administering my erenumab injections?
Erenumab is available as a pre-filled pen and is to be self-administered. Prior to administering your first injection, please watch the video demo and read through the FAQs available at www.aimovig.com/start/aimovig-injection. If you require further assistance with self-administering, please see contact list below for the details of who to contact.

Q5. What do I need to do to after I have started my erenumab injections?
It is a mandatory requirement that all patients are reviewed after around 12-weeks to assess response to treatment. To be able to do this, your consultant will require your headache diaries to ensure this review occurs in a timely manner. Once reviewed your follow-up prescription can be arranged, if there is adequate response.

Q6. Who should I contact if I have a query?

• Query relating to prescription delivery, contact Healthnet on 08001932027
• Query relating to your prescription, contact Healthnet on 08001932027
• Query relating to your headache diaries, contact your consultant’s secretary