Complete Resolution of New Daily Persistent Headache With Migraine-Like Features Following Erenumab Treatment: A Case Report

TL;DR

A woman with a rare headache disorder found complete relief after treatment with erenumab, suggesting it may help similar cases.

Contribution

This case report demonstrates the potential efficacy of erenumab in treating New Daily Persistent Headache with migraine-like features.

Findings

A 46-year-old woman achieved complete and sustained remission of her headache after erenumab treatment.

The treatment was effective over 24 months without recurrence of symptoms.

The case suggests that calcitonin gene-related peptide-targeted therapy may benefit patients with migraine-like NDPH phenotypes.

Abstract

New daily persistent headache (NDPH) is a rare and difficult-to-treat primary headache disorder characterized by a sudden onset of continuous, unremitting pain. We report the case of a 46-year-old Japanese woman with a history of episodic migraine who developed a persistent daily headache with migraine-like features. Despite multiple conventional preventive treatments, her symptoms remained unchanged. Remarkably, she achieved complete and sustained remission after initiating monthly subcutaneous injections of erenumab at a dose of 70 mg. The treatment was maintained for 24 months, during which no recurrence of the continuous headache occurred. This case highlights the diagnostic overlap between NDPH and chronic migraine presenting with continuous daily headache and suggests the potential benefit of calcitonin gene-related peptide-targeted therapy in patients with migraine-like NDPH phenotypes. Careful phenotypic characterization may improve therapeutic decision-making and support a syndromic approach to managing continuous daily headache disorders.

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