IntroductionErenumab is available in Australia since October 2018. We review the effectiveness and safety in 2 Australian headache centres.MethodsErenumab (70 mg or 140 mg) was prescribed. We monitored headache days, migraine days, analgesic use, adverse reactions, Headache Impact Test-6 (HIT6) score and Migraine Disability Assessment (MiDAS) score, at baseline and at 3 months. Primary outcomes were reduction in headache and migraine days, and adverse effects. Secondary outcomes were improvement in functional scores and analgesic use.Results65 patients (ages 18–73; mean 44 years) commencing Erenumab were assessed before and after 3 monthly treatments. The duration of chronic migraine (CM) ranged from 1 to 40 years, with 3 to 16 previous failed prophylactic treatments.There was a >50% response in overall headache days and migraine days in 29% (19/65) and 46% (27/59), respectively. There was a modest (10–49%) response in overall headache days and migraine days in 29% (19/65) and 27% (18/59), respectively. There was no improvement in headache days and migraines in 42% (27/65) and 27% (14/59), respectively.At onset, the mean HIT-6 and MiDAS scores were 66 and 65, decreasing after 3 treatments to 59 and 32, respectively. The mean monthly days taking triptan and codeine medications reduced from 9 and 6 days, to 5 and 3 days, respectively.There were few reported side effects.ConclusionThis Australian cohort in tertiary referral refractory migraine patients achieved a significant rate of reduced headache and migraine days with good safety and tolerability.