Mekanizma Temelli Migren Tedavisinde Erenumab

Özge, Aynur; karadaş, ömer; Bozkurt, Manal; Uluduz, Derya

doi:10.4274/tnd.2021.08784

Mekanizma Temelli Migren Tedavisinde Erenumab

Aynur ÖZGE, (Mersin Üniversitesi, Tıp Fakültesi, Nöroloji Anabilim Dalı, Mersin, Türkiye)

Derya ULUDÜZ, (İstanbul Üniversitesi Cerrahpaşa, Cerrahpaşa Tıp Fakültesi, Nöroloji Anabilim Dalı, İstanbul, Türkiye)

Ömer KARADAŞ, (Sağlık Bilimleri Üniversitesi, Gülhane Eğitim ve Araştırma Hastanesi, Nöroloji Anabilim Dalı, Ankara, Türkiye)

Manal BOZKURT (Novartis İlaç, İstanbul, Türkiye)

Türk Nöroloji Dergisi

48 3

Yıl: 2021 Cilt: 27 Sayı: 3 Sayfa Aralığı: 229 - 239 Metin Dili: Türkçe DOI: 10.4274/tnd.2021.08784 İndeks Tarihi: 14-01-2022

Mekanizma Temelli Migren Tedavisinde Erenumab

Öz:

Migren ataklarla seyreden, şiddetli olması nedeniyle kişinin günlük yaşam aktivitelerini olumsuz etkileyen ve önemli ekonomik yüke neden olan primer baş ağrısıdır. Migrenin ekonomik, sosyal ve fiziksel yükü ağrı sıklığındaki artış ile birlikte artmaktadır. Özellikle kronik migrenli (KM) veya sık atak geçiren epizodik migrenli (EM) hastalarda mekanizma temelli tedavilere ihtiyaç her geçen gün daha fazla hissedilmektedir. Konvansiyonel önleyici tedaviler esasen farklı hastalıklara yönelik olarak geliştirilmiş, migren baş ağrısında da etkili oldukları çalışmalarda gösterilmiş tedavilerdir. Bu tedavilerin etkililiği ve istenmeyen etkileri ile ilgili sorunlar migrenli hastalarda yeterli süreyle kullanımlarını kısıtlamaktadır; çoğu hasta etkisiz atak tedavileri nedeniyle ilaç aşırı kullanım baş ağrısı riski altındadır. Yakın dönemde migren patofizyolojisinin daha iyi anlaşılması migrene özgü tedavilerin geliştirilmesine yönelik araştırmalara yeni bir yön vermiştir. Kalsitonin gen ilişkili peptid (CGRP), migren patogenezindeki rolüne ilişkin ipuçlarıyla dikkatleri üzerine çekmiş ve 1990’lı yıllardan başlayarak ilaç araştırmalarının odağı haline gelmiştir. Migren tedavisine yönelik ilk geliştirilen ve kullanıma giren monoklonal antikor erenumabdır. CGRP reseptörüne karşı geliştirilmiş tek terapötik antikor olması ile migren profilaksisinde kullanılan ve CGRP ligandını hedef alan diğer monoklonal antikorlardan ayrışır. Erenumab insan yapısıyla tamamen aynı “(human)” olacak şekilde tasarlanmıştır; immünoglobulin G2 sınıfında yer alan, immünomodülatör etkisi olmayan bir monoklonal antikordur. Yüksek afinite ve seçicilikle CGRP reseptörünü bloke edip CGRP ligandının bu reseptöre bağlanmasını engeller. Kalsitonin ailesindeki diğer reseptörler üzerinde önemli bir etkisi bulunmamaktadır. EM ve KM’li hastalarda ağrılı gün sayısını ve atak tedavisine olan ihtiyacı azaltmada etkili bulunmuş, hasta geri bildirim sonuçlarını iyileştirmiştir.

Anahtar Kelime:

Erenumab in Mechanism-based Migraine Treatment

Öz:

Migraine is a type of primary headache with recurrent attacks, negatively affects the daily living activities of sufferers because of its severity, and causes a heavy economic burden. The economic, social, and physical burdens of migraine grow with the increasing frequency of headache attacks. Mechanism-based treatments are increasingly needed, especially for those with chronic migraine (CM) or episodic migraine (EM) with frequent attacks. Conventional migraine-preventive medications have been essentially developed for some other diseases and shown to be also effective against migraine headaches. Efficacy, safety, and tolerability issues limit their use for an adequate duration, and most patients are under the risk of medication-overuse headache because of the ineffectiveness of attack treatments. In recent decades, a better understanding of migraine pathophysiology has given a new direction to migraine drug research to fulfill the unmet need for the development of migraine-specific medications. Calcitonin gene-related peptide (CGRP) has attracted attention with its potential role in migraine pathogenesis and has become the focus of drug research in this area as of the 1990s. The first monoclonal antibody developed and approved for the treatment of migraine is erenumab. Being the only therapeutic antibody against the CGRP receptor, erenumab differs from the other monoclonal antibodies for migraine prevention that target the CGRP ligand. Erenumab is a fully human, immunoglobulin G2 class monoclonal antibody with no immunomodulatory effect. It blocks the CGRP receptor with high affinity and selectivity and prevents binding of the CGRP ligand to this receptor. It does not have a significant effect on other receptors in the calcitonin receptor family. Erenumab has been shown to diminish the number of migraine days and the need for attack treatment and to improve patient-reported outcomes in patients with EM and CM.

Anahtar Kelime:

Belge Türü: Makale Makale Türü: Derleme Erişim Türü: Erişime Açık

1. Headache Classification Committee of the International Headache Society (IHS) the International Classification of Headache Disorders, 3rd edition. Cephalalgia 2018;38:1-211.
2. Raggi A, Giovannetti AM, Quintas R, et al. A systematic review of the psychosocial difficulties relevant to patients with migraine. J Headache Pain 2012;13:595-606.
3. Martelletti P, Schwedt TJ, Lanteri-Minet M, et al. My Migraine Voice survey: a global study of disease burden among individuals with migraine for whom preventive treatments have failed. J Headache Pain 2018;19:115.
4. Leonardi M, Raggi A. A narrative review on the burden of migraine: when the burden is the impact on people’s life. J Headache Pain 2019;20:41.
5. Doane MJ, Gupta S, Fang J, Laflamme AK, Vo P. The Humanistic and Economic Burden of Migraine in Europe: A Cross-Sectional Survey in Five Countries. Neurol Ther 2020;9:535-549.
6. Bigal ME, Serrano D, Buse D, et al. Acute migraine medications and evolution from episodic to chronic migraine: a longitudinal populationbased study. Headache 2008;48:1157-1168.
7. Lipton RB, Fanning KM, Buse DC, et al. Migraine progression in subgroups of migraine based on comorbidities: Results of the CaMEO Study. Neurology 2019;93:e2224-e2236.
8. Çimen Atalar A, Yalın OÖ. Investigation of the risk factors for the transition of episodic migraines to chronic migraines. Agri 2019;31:172-177.
9. Institute for Health Metrics and Evaluation website. GBD 2019 results tool http://ghdx.healthdata.org/gbd-results-tool Accessed date: 15.03.2021.
10. Ertas M, Baykan B, Orhan EK, et al. One-year prevalence and the impact of migraine and tension-type headache in Turkey: a nationwide home-based study in adults. J Headache Pain 2012;13:147-157.
11. Baykan B, Ertas M, Karlı N, et al. Migraine incidence in 5 years: a population-based prospective longitudinal study in Turkey. J Headache Pain 2015;16:103.
12. Steiner TJ, Stovner LJ, Vos T, Jensen R, Katsarava Z. Migraine is first cause of disability in under 50s: will health politicians now take notice?. J Headache Pain 2018;19:17.
13. Lipton RB, Silberstein SD. Episodic and chronic migraine headache: breaking down barriers to optimal treatment and prevention. Headache. 2015;55(Suppl 2):103-126.
14. Bloudek LM, Stokes M, Buse DC, et al. Cost of healthcare for patients with migraine in five European countries: results from the International Burden of Migraine Study (IBMS). J Headache Pain 2012;13:361-378.
15. Manack A, Buse DC, Serrano D, Turkel CC, Lipton RB. Rates, predictors, and consequences of remission from chronic migraine to episodic migraine. Neurology 2011;76:711-718.
16. Fanciullacci M, De Cesaris F. Preventing chronicity of migraine. J Headache Pain 2005;6:331-333.
17. Gürsoy AE, Ertaş M. Prophylactic Treatment of Migraine. Noro Psikiyatr Ars. 2013;50(Suppl 1):30-35.
18. American Headache Society. The American Headache Society Position Statement on Integrating New Migraine Treatments into Clinical Practice. Headache 2019;59:1-18.
19. Öztürk M. Primer Başağrıları Migren- Atak ve Önleyici Tedavi. Şebnem Bıçakcı, Musa Öztürk, Serap Üçler, Necdet Karlı, Aksel Siva Başağrısı Tanı ve Tedavi Güncel Yaklaşımlar 1. Baskı İstanbul, Basım yeri: Üniform Basım San. ve Turizm Ltd. Şti., Yayınevi: Galenos Yayınevi, 2018:51-66.
20. Blumenfeld AM, Bloudek LM, Becker WJ, et al. Patterns of use and reasons for discontinuation of prophylactic medications for episodic migraine and chronic migraine: results from the second international burden of migraine study (IBMS-II). Headache 2013;53:644-655.
21. Hepp Z, Dodick DW, Varon SF, et al. Persistence and switching patterns of oral migraine prophylactic medications among patients with chronic migraine: A retrospective claims analysis. Cephalalgia 2017;37:470-485.
22. Bonafede M, McMorrow D, Noxon V, et al. Care Among Migraine Patients in a Commercially Insured Population. Neurol Ther 2020;9:93-103.
23. Russo AF. Calcitonin gene-related peptide (CGRP): a new target for migraine. Annu Rev Pharmacol Toxicol 2015;55:533-552.
24. Edvinsson L, Haanes KA, Warfvinge K, Krause DN. CGRP as the target of new migraine therapies - successful translation from bench to clinic. Nat Rev Neurol 2018;14:338-350.
25. Edvinsson L. The CGRP Pathway in Migraine as a Viable Target for Therapies. Headache 2018;58(Suppl 1):33-47.
26. Levin M, Silberstein SD, Gilbert R, et al. Basic Considerations for the Use of Monoclonal Antibodies in Migraine. Headache 2018;58:1689-1696.
27. Tepper D. Gepants. Headache 2020;60:1037-1039.
28. Hargreaves R, Olesen J. Calcitonin Gene-Related Peptide Modulators - The History and Renaissance of a New Migraine Drug Class. Headache 2019;59:951-970.
29. Lassen LH, Haderslev PA, Jacobsen VB, et al. CGRP may play a causative role in migraine. Cephalalgia 2002;22:54-61.
30. Edvinsson L, Warfvinge K. Recognizing the role of CGRP and CGRP receptors in migraine and its treatment. Cephalalgia 2019;39:366-373.
31. Shi L, Lehto SG, Zhu DX, et al. Pharmacologic Characterization of AMGS 334, a Potent and Selective Human Monoclonal Antibody against the Calcitonin Gene-Related Peptide Receptor. J Pharmacol Exp Ther 2016;356:223-231.
32. Sacco S, Bendtsen L, Ashina M, et al. European headache federation guideline on the use of monoclonal antibodies acting on the calcitonin gene related peptide or its receptor for migraine prevention. J Headache Pain 2019;20:6. Erratum in: J Headache Pain 2019;20:58.
33. New Drug Approvals in the USA, Europe and Japan Available from: https:// www.genome.jp/kegg/drug/br08328.html. Access date:15.03.2021.
34. Andreou AP, Fuccaro M, Lambru G. The role of erenumab in the treatment of migraine. Ther Adv Neurol Disord 2020;13:1756286420927119.
35. AIMOVIG (Erenumab-aooe) label. Available from: https://www.accessdata. fda.gov/drugsatfda_docs/label/2018/761077s000lbl.pdf Access date: 10.08.2020.
36. AJOVY (Fremanezumab-vfrm) label. Available from: https://www. accessdata.fda.gov/drugsatfda_docs/label/2018/761089s000lbl.pdf Access date: 10.08.2020.
37. EMGALTY (Galcanezumab-gnlm) label. Available from: https://www. accessdata.fda.gov/drugsatfda_docs/label/2019/761063s003lbl.pdf Access date: 10.08.2020.
38. Eptinezumab full prescribing information Available from: https://www. accessdata.fda.gov/drugsatfda_docs/label/2020/761119s000lbl.pdf Access date: 10.08.2020.
39. King CT, Gegg CV, Hu SN, et al. Discovery of the Migraine Prevention Therapeutic Aimovig (Erenumab), the First FDA-Approved Antibody against a G-Protein-Coupled Receptor. ACS Pharmacol Transl Sci 2019;2:485-490.
40. Vidarsson G, Dekkers G, Rispens T. IgG subclasses and allotypes: from structure to effector functions. Front Immunol 2014;5:520.
41. Hui GK, Gardener AD, Begum H, et al. The solution structure of the human IgG2 subclass is distinct from those for human IgG1 and IgG4 providing an explanation for their discrete functions. J Biol Chem 2019;294:10789- 10806.
42. Sun H, Dodick DW, Silberstein S, et al. Safety and efficacy of AMGS 334 for prevention of episodic migraine: a randomised, double-blind, placebocontrolled, phase 2 trial. Lancet Neurol 2016;15:382-390.
43. Tepper S, Ashina M, Reuter U, et al. Safety and efficacy of erenumab for preventive treatment of chronic migraine: a randomised, double-blind, placebo-controlled phase 2 trial. Lancet Neurol 2017;16:425-434.
44. Goadsby PJ, Reuter U, Hallström Y, et al. A Controlled Trial of Erenumab for Episodic Migraine. N Engl J Med 2017;377:2123-2132.
45. Dodick DW, Ashina M, Brandes JL, et al. ARISE: A Phase 3 randomized trial of erenumab for episodic migraine. Cephalalgia 2018;38:1026-1037.
46. Reuter U, Goadsby PJ, Lanteri-Minet M, et al. Efficacy and tolerability of erenumab in patients with episodic migraine in whom two-to-four previous preventive treatments were unsuccessful: a randomised, double-blind, placebo-controlled, phase 3b study. Lancet 2018;392:2280-2287.
47. Erenumab Kısa ürün bilgisi Available at: https://titck.gov.tr/storage/ Archive/2021/kubKtAttachments/kuzelva70onaylkb_d3c7d61c-3562- 4b9f-8a8b-7317b66cad57.pdf Access date: 30.03.2021.
48. Schwedt T, Reuter U, Tepper S, et al. Early onset of efficacy with erenumab in patients with episodic and chronic migraine. J Headache Pain 2018;19:92.
49. Ashina M, Goadsby PJ, Reuter U, et al. Long-term efficacy and safety of erenumab in migraine prevention: Results from a 5-year, open-label treatment phase of a randomized clinical trial. Eur J Neurol 2021;28:1716- 1725.
50. Goadsby PJ, Reuter U, Hallström Y, et al. One-year sustained efficacy of erenumab in episodic migraine: Results of the STRIVE study. Neurology 2020;95:e469-e479.
51. Tepper SJ, Ashina M, Reuter U, et al. Long-term safety and efficacy of erenumab in patients with chronic migraine: Results from a 52-week, openlabel extension study. Cephalalgia 2020;40:543-553.
52. Goadsby PJ, Paemeleire K, Broessner G, et al. Efficacy and safety of erenumab (AMGS334) in episodic migraine patients with prior preventive treatment failure: A subgroup analysis of a randomized, double-blind, placebo-controlled study. Cephalalgia 2019;39:817-826.
53. Reuter U, Schwedt TJ, Kudrow D, et al. Long-term Efficacy of Erenumab in Patients With Episodic Migraine Who Have Failed Prior Preventive Migraine Therapies (P1.10-020). Abstracts: AAN 71st Annual Meeting, Philadelphia, USA. Neurology 2019;92(15 Suppl)10-020.
54. Reuter U, Goadsby PJ, Lanteri-Minet M, et al. Sustained efficacy and safety of erenumab in patients with episodic migraine who failed 2–4 prior preventive treatments: 2-year interim results of the LIBERTY open-label extension study. Abstracts: AHS 62nd Annual Scientific Meeting (Virtual). Headache 2020;60(SI suppl):96.
55. Lipton RB, Tepper SJ, Silberstein SD, et al. Reversion from chronic migraine to episodic migraine following treatment with erenumab: Results of a posthoc analysis of a randomized, 12-week, double-blind study and a 52-week, open-label extension. Cephalalgia 2021;41:6-16.
56. Ashina M, Tepper S, Brandes JL, et al. Efficacy and safety of erenumab (AMGS334) in chronic migraine patients with prior preventive treatment failure: A subgroup analysis of a randomized, double-blind, placebocontrolled study. Cephalalgia 2018;38:1611-1621.
57. Tepper SJ, Diener HC, Ashina M, et al. Erenumab in chronic migraine with medication overuse: Subgroup analysis of a randomized trial. Neurology 2019;92:e2309-e2320.
58. Tepper SJ, Dodick DW, Lucas S, et al. Efficacy of Erenumab in Chronic Migraine (CM) Patients With Acute Headache Medication Overuse (MO): A Post Hoc Analysis Assessing Outcomes Using Different Definitions of Remission. AHS 62nd Annual Scientific Meeting (Virtual). Headache 2020;60(S1 suppl):105.
59. Tepper S, Lipton R, Silberstein S, et al. Long-term efficacy of erenumab in chronic migraine (CM) patients with or without acute medication overuse (AMO). Neurology 2020;94(15 Suppl):006.
60. Lipton RB, Buse DC, Dodick DW, et al. Efficacy of Erenumab in Chronic Migraine Patients with and Without Allodynia. Abstracts: AHS 61st Annual Scientific Meeting Philadelphia, USA. Headache 2019;59(SI suppl):101.
61. Buse DC, Lipton RB, Hallström Y, et al. Migraine-related disability, impact, and health-related quality of life among patients with episodic migraine receiving preventive treatment with erenumab. Cephalalgia 2018;38:1622- 1631.
62. Lipton RB, Tepper SJ, Reuter U, et al. Erenumab in chronic migraine: Patient-reported outcomes in a randomized double-blind study. Neurology 2019;92:e2250-e2260.
63. Pascual J, Buse DC, Starling A, et al. Effect of erenumab on patient-reported outcomes in episodic migraine patients with prior prophylactic treatment failure: Results from a post-hoc analysis of the STRIVE study (065). MTIS 2018 Abstracts. Cephalalgia 2018;38(1_suppl):1-115.
64. Lanteri-Minet M, Buse CD, Staarling A, et al. Patient-Reported Outcomes in chronic migraine patients with prior prophylactic treatment failure receiving placebo or erenumab: subgroup analysis of a pivotal randomised study (066). MTIS 2018 Abstracts. Cephalalgia 2018;38(1_suppl):1-115.
65. Lattanzi S, Brigo F, Trinka E, et al. Erenumab for Preventive Treatment of Migraine: A Systematic Review and Meta-Analysis of Efficacy and Safety. Drugs 2019;79:417-431.
66. Zhu C, Guan J, Xiao H, Luo W, Tong R. Erenumab safety and efficacy in migraine: A systematic review and meta-analysis of randomized clinical trials. Medicine (Baltimore) 2019;98:e18483.
67. Lampl C, Snellman J, Ritter S, Klatt J. Safety and tolerability of erenumab in older migraine patients: A subgroup analysis of randomised trials (1207). Neurology 2020;94 (15 Suppl):1207.
68. Kudrow D, Pascual J, Winner PK, et al. Vascular safety of erenumab for migraine prevention. Neurology 2020;94:e497-e510. Erratum in: Neurology 2020;94:1052.
69. Drug Safety-related Labeling Changes. Available from: https:// www.accessdata.fda.gov/scripts/cder/safetylabelingchanges/index. cfm?event=searchdetail.page&DrugNameID=1894# Access date: 15.08.2020.
70. Franklin SS, Khan SA, Wong ND, Larson MG, Levy D. Is pulse pressure useful in predicting risk for coronary heart disease? The Framingham heart study. Circulation 1999;100:354-360.
71. Franklin SS, Larson MG, Khan SA, et al. Does the relation of blood pressure to coronary heart disease risk change with aging? The Framingham heart study. Circulation 2001;103:1245-1249.
72. Ashina M, Kudrow D, Reuter U, et al. Long-term tolerability and nonvascular safety of erenumab, a novel calcitonin gene-related peptide receptor antagonist for prevention of migraine: A pooled analysis of four placebo-controlled trials with long-term extensions. Cephalalgia 2019;39:1798-1808.
73. Vargas B, Starling A, Silberstein S, et al. Erenumab Immunogenicity: a Pooled Analysis of Phase 2 and Phase 3 Migraine Prevention Clinical Trials (P4.098). Abstracts: AAN 70th Annual Meeting, Los Angeles Neurology Apr 2018, 90(15 Suppl):098.
74. Barbanti P, Aurilia C, Cevoli S, et al. The First, Italian, Multicenter, Reallife Study with Erenumab in the Prevention of High Frequency Episodic and Chronic Migraine. Neurology 2020;94(15 Suppl):2307.
75. Russo A, Silvestro M, Scotto di Clemente F, et al. Multidimensional assessment of the effects of erenumab in chronic migraine patients with previous unsuccessful preventive treatments: a comprehensive real-world experience. J Headache Pain 2020;21:69.
76. Hines D, Shah S, Multani J, et al. Changes in Acute Migraine-Specific Medications after Initiating Erenumab: Results from a Real-World Retrospective Cohort Study in the United States (EPR 3047). Abstracts of the 6th Congress of the European Academy of Neurology (virtual congress). Eur J of Neurol 2020;27(Suppl 1):103-502.
77. Zyloney C, Barker C, Yu Y, Villanueva R, Schwarz H. Post marketing experiences with erenumab (Aimovig) for the treatment of chronic migraine in a real life clinical setting. Neurology 2020; 94(15 Suppl):254.
78. Gaul C, Israel-Willner H, Schuh K, Koch M. First-Hand Impressions of the monoclonal Antibody in Migraine Prevention from Patients treated with Erenumab in Germany. Neurology 2020;94(15 Suppl):3997.
79. Straube A, Stude P, Gaul C, Koch M, Schuh K. First one-year real world evidence data with the monoclonal antibody erenumab in Germany. Neurology 2020;94(15 Suppl):1873.

APA	Özge A, Uluduz D, karadaş ö, Bozkurt M (2021). Mekanizma Temelli Migren Tedavisinde Erenumab. , 229 - 239. 10.4274/tnd.2021.08784
Chicago	Özge Aynur,Uluduz Derya,karadaş ömer,Bozkurt Manal Mekanizma Temelli Migren Tedavisinde Erenumab. (2021): 229 - 239. 10.4274/tnd.2021.08784
MLA	Özge Aynur,Uluduz Derya,karadaş ömer,Bozkurt Manal Mekanizma Temelli Migren Tedavisinde Erenumab. , 2021, ss.229 - 239. 10.4274/tnd.2021.08784
AMA	Özge A,Uluduz D,karadaş ö,Bozkurt M Mekanizma Temelli Migren Tedavisinde Erenumab. . 2021; 229 - 239. 10.4274/tnd.2021.08784
Vancouver	Özge A,Uluduz D,karadaş ö,Bozkurt M Mekanizma Temelli Migren Tedavisinde Erenumab. . 2021; 229 - 239. 10.4274/tnd.2021.08784
IEEE	Özge A,Uluduz D,karadaş ö,Bozkurt M "Mekanizma Temelli Migren Tedavisinde Erenumab." , ss.229 - 239, 2021. 10.4274/tnd.2021.08784
ISNAD	Özge, Aynur vd. "Mekanizma Temelli Migren Tedavisinde Erenumab". (2021), 229-239. https://doi.org/10.4274/tnd.2021.08784

APA	Özge A, Uluduz D, karadaş ö, Bozkurt M (2021). Mekanizma Temelli Migren Tedavisinde Erenumab. Türk Nöroloji Dergisi, 27(3), 229 - 239. 10.4274/tnd.2021.08784
Chicago	Özge Aynur,Uluduz Derya,karadaş ömer,Bozkurt Manal Mekanizma Temelli Migren Tedavisinde Erenumab. Türk Nöroloji Dergisi 27, no.3 (2021): 229 - 239. 10.4274/tnd.2021.08784
MLA	Özge Aynur,Uluduz Derya,karadaş ömer,Bozkurt Manal Mekanizma Temelli Migren Tedavisinde Erenumab. Türk Nöroloji Dergisi, vol.27, no.3, 2021, ss.229 - 239. 10.4274/tnd.2021.08784
AMA	Özge A,Uluduz D,karadaş ö,Bozkurt M Mekanizma Temelli Migren Tedavisinde Erenumab. Türk Nöroloji Dergisi. 2021; 27(3): 229 - 239. 10.4274/tnd.2021.08784
Vancouver	Özge A,Uluduz D,karadaş ö,Bozkurt M Mekanizma Temelli Migren Tedavisinde Erenumab. Türk Nöroloji Dergisi. 2021; 27(3): 229 - 239. 10.4274/tnd.2021.08784
IEEE	Özge A,Uluduz D,karadaş ö,Bozkurt M "Mekanizma Temelli Migren Tedavisinde Erenumab." Türk Nöroloji Dergisi, 27, ss.229 - 239, 2021. 10.4274/tnd.2021.08784
ISNAD	Özge, Aynur vd. "Mekanizma Temelli Migren Tedavisinde Erenumab". Türk Nöroloji Dergisi 27/3 (2021), 229-239. https://doi.org/10.4274/tnd.2021.08784