Abstract Details

Title The Impact of Fremanezumab on Medication Overuse in Patients With Chronic Migraine

Topic Headache

Presentation(s) P1 - Poster Session 1 (5:30 PM-6:30 PM)

Poster/Presentation
Number 13-026

Objective To assess the effect of fremanezumab versus placebo on medication overuse and acute headache medication use in patients with chronic migraine (CM).

Background

Overuse of acute or symptomatic headache medications, such as triptans, ergot derivatives, opioids, and combination analgesics, can cause medication overuse headache (MOH). CM is often accompanied by MOH. Fremanezumab, a fully humanized monoclonal antibody (IgG2Δa) that selectively targets calcitonin gene-related peptide (CGRP), is efficacious in preventing CM.

Design/Methods In this Phase 3, multicenter, randomized, double-blind, placebo-controlled study, CM patients were randomized 1:1:1 to receive subcutaneous fremanezumab quarterly (675 mg at baseline, and placebo at Weeks 4 and 8), fremanezumab monthly (675 mg at baseline, and 225 mg at Weeks 4 and 8), or placebo (at baseline, Weeks 4 and 8). We assessed the proportion of patients who reverted from overusing medications at baseline to not overusing medications during the 12-week treatment period, and the change from baseline in the number of days of acute headache medication use.

Results Among patients with medication overuse at baseline (quarterly n=201; monthly n=198; placebo n=188), more patients treated with fremanezumab reported no medication overuse during the treatment period (quarterly: 55%, P=0.0389; monthly: 61%, P=0.0024) than those who received placebo (46%). Response to treatment was seen by Week 4 (quarterly: 51%, P=0.0091; monthly: 54%, P=0.0014; vs placebo: 39%). Among the patients who responded to treatment, the baseline number of days with medication overuse was similar across treatment groups (quarterly [mean]: 16.6 days; monthly: 16.7 days; placebo: 16.6). Within this population, fremanezumab treatment significantly reduced the days of acute headache medication use (quarterly: –9.0 days, P=0.0017; monthly: –8.9 days, P=0.0040) compared with those who received placebo (–7.1 days).

Conclusions

Fremanezumab treatment was associated with a reduction in overuse of acute medications and a corresponding decrease in days using acute medications.

Authors/Disclosures
Stephen D. Silberstein, MD, FAAN PRESENTER	Dr. Silberstein has received publishing royalties from a publication relating to health care.
Sait Ashina, MD (Beth Israel Deaconess Medical Center, Harvard Medical School)	Dr. Ashina has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Eli Lilly. Dr. Ashina has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Allergan/Abbvie. Dr. Ashina has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Theranica. Dr. Ashina has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Linpharma. Dr. Ashina has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Teva. Dr. Ashina has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Lundbeck. Dr. Ashina has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Pfizer.
Zaza Katsarava, MD	Zaza Katsarava, MD has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Allergan. Zaza Katsarava, MD has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Lilly. Zaza Katsarava, MD has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis. Zaza Katsarava, MD has received personal compensation in the range of $500-$4,999 for serving as a Consultant for TEVA. Zaza Katsarava, MD has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Lilly. Zaza Katsarava, MD has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Teva. Zaza Katsarava, MD has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Novartis.
	No disclosure on file
Michael Seminerio	Michael Seminerio has received personal compensation for serving as an employee of AbbVie.
Danielle E. Harlow, PhD	No disclosure on file
Joshua M. Cohen, MD	No disclosure on file

��ɫ��

��ɫ��