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MS Spasticity – Goals — SCE Neurology MCQ

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HardMultiple Sclerosis & CNS InflammationMS Spasticity – GoalsSCE Neurology

A patient with chronic migraine had 20 migraine days per month before erenumab 140 mg. After 12 weeks the average is 15 days, with good tolerability. What does NICE TA682 require?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: D — Stop erenumab because a 25% reduction is below the 30% chronic-migraine threshold

Explanation lettering: D = shown as A · E = shown as B · B = shown as C · C = shown as D · A = shown as E

C is correct: 20 to 15 days is a 25% reduction, below NICE’s 30% minimum response for chronic migraine at 12 weeks. A invents a two-day rule. B states the wrong threshold and still would not justify continuation. D delays the mandated assessment. E reverses the dose logic and is outside the TA682 recommendation, which specifies 140 mg. The calculation and chronic-versus-episodic distinction are both necessary.

Reference: NICE TA682: erenumab for preventing migraine: https://www.nice.org.uk/guidance/ta682/chapter/1-Recommendations