Objective:

To evaluate effectiveness and tolerability of fremanezumab in patients who experienced poor effectiveness or tolerability with a prior calcitonin gene-related peptide (CGRP) pathway targeted therapy.

Background:

Fremanezumab, a humanized monoclonal antibody, selectively targets CGRP, and is authorised for preventive treatment of episodic and chronic migraine (EM, CM) in adults with ≥4 migraine days/month. Here we present interim, subgroup analysis, data from FINESSE.

Design/Methods:

FINESSE is an ongoing, multicenter, prospective, observational study in adults with EM or CM in a real-world setting, with follow-up at 24 months .Primary endpoint: proportion of patients reaching ≥50% reduction in the average number of monthly migraine days (MMD) over 6 months post-initial dose. Secondary endpoints: monthly average number of MMDs; disability scores (Migraine Disability Assessment questionnaire [MIDAS], Six-Item Headache Impact Test [HIT-6]), concomitant acute migraine medication use.

Results:

Of the 158 patients (84.8% female) evaluated, 82 (51.9%) were diagnosed with EM. The most common reasons for switching to fremanezumab were inadequate response, intolerability, or combination of both. 59 patients (37.3% patients in the intention-to-treat analysis) achieved a reduction in MMDs ≥50% over 3 months (EM; 43.9% versus CM; 30.3%). 12 patients (7.6%) discontinued treatment within the first 3 months. Average number of MMDs decreased (13.5±6.43 [baseline] to 7.2±5.39 [3 months]) as did the average MIDAS (68.4±54.0 [baseline] to 53.2±57.5 [3 months] and HIT-6 scores (65.0±5.0 [baseline] to 60.5±7.2 [3 months]). Acute migraine medication use also decreased (9.8±5.29 days/month [baseline] to 4.7±4.78 days/month [3 months]).

Conclusions: