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Erenumab: CGRP-Receptor Biology, Migraine Prevention and Product Pharmacovigilance

Test your understanding of the concepts covered by Erenumab: CGRP-Receptor Biology, Migraine Prevention and Product Pharmacovigilance.

Question 1 of 10Pass mark: 80%

Question 1 of 10 A report states only that the patient's migraine treatment 'did not work' after one injection. What is the most important initial follow-up?

Assume pharmacological failure because any headache proves lack of efficacy Establish baseline migraine frequency, exposure duration and whether the full dose was delivered Classify the report as a serious adverse reaction because efficacy was absent Disregard the report because preventive medicines cannot be assessed in pharmacovigilance

Question 2 of 10 A patient reports worsening migraine after removing an autoinjector immediately after activation, with fluid observed on the skin. What should be assessed first?

Whether the full intended dose was delivered Whether the patient has developed Raynaud's phenomenon Whether CGRP ligand antibodies have been produced Whether the patient should be classified as a treatment responder

Question 3 of 10 Which clinical outcome is most appropriate for evaluating preventive benefit over time?

Whether the patient experienced any headache during the first 24 hours after injection Monthly migraine days, acute-medication use, disability and persistence of benefit The colour of the injection device and the time of day of administration A single post-treatment blood pressure measurement

Question 4 of 10 Which exposure information is especially useful when assessing a suspected erenumab adverse event?

Dose, administration date, regimen, device and lot number if available Only the date on which the patient first experienced migraine Only the patient's age, without treatment chronology The number of headache symptoms listed in a patient diary, without dosing information

Question 5 of 10 Which description most accurately distinguishes erenumab from ligand-directed CGRP monoclonal antibodies?

Erenumab binds circulating CGRP, whereas ligand-directed antibodies bind the CGRP receptor Erenumab blocks the canonical CGRP receptor, whereas ligand-directed antibodies bind CGRP itself Erenumab inhibits CGRP synthesis inside the central nervous system, whereas ligand-directed antibodies inhibit peripheral synthesis Erenumab blocks serotonin receptors, whereas ligand-directed antibodies block trigeminal sodium channels

Question 6 of 10 Which statement best reflects the article's description of migraine biology?

Migraine is primarily an isolated disorder of cranial blood-vessel constriction Migraine is a distributed neurological state involving trigeminovascular signalling and altered sensory processing Migraine symptoms are caused only by excessive CGRP concentrations in the brain Migraine is principally a gastrointestinal motility disorder with secondary headache

Question 7 of 10 Which finding would most strongly indicate that constipation has progressed to a serious complication requiring enhanced case assessment?

A temporary change in preferred meal time Abdominal distension with imaging-confirmed obstruction and hospitalisation One day without a bowel movement in a patient with no symptoms A mild injection-site reaction occurring on the same day

Question 8 of 10 Which pregnancy-case information is most important for interpreting exposure to erenumab?

Timing of exposure during pregnancy, estimated due date, other migraine therapies and pregnancy outcome Only the patient's preferred injection site Only the number of migraine days before pregnancy Whether the patient used an autoinjector or syringe, without exposure timing

Question 9 of 10 Which statement best characterises the relationship between CGRP blockade and hypertension?

CGRP blockade inevitably causes hypertension in all treated patients Loss of a compensatory vasodilatory signal provides biological plausibility, but hypertension remains an individual and multifactorial event Hypertension can only occur through a direct antibody effect on renal filtration Hypertension is incompatible with CGRP-receptor blockade because CGRP is exclusively nociceptive

Question 10 of 10 Which information would most improve assessment of a report of new hypertension after erenumab?

Only the patient's migraine aura status Baseline and repeated blood-pressure measurements, timing relative to dosing, comorbidities and antihypertensive treatment The colour and packaging of the autoinjector, without clinical measurements Whether the patient had photophobia during the last migraine

Erenumab: CGRP-Receptor Biology, Migraine Prevention and Product Pharmacovigilance

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