This retrospective, real-world claims analysis assessed changes in acute medication use prior to first fremanezumab initiation and during a 12-month follow-up period.

Fremanezumab is approved for preventive treatment of chronic migraine (CM) and episodic migraine (EM) in adults. A prior claims database study showed reductions in acute medication claims 6 months post-initiation of fremanezumab versus 6 months pre-initiation. Data from a 12-month follow-up have recently become available.

The IBM Marketscan Commercial and Medicare database was used to identify adult patients (≥18 years) with ≥1 pharmacy claim for fremanezumab from September 1, 2018–March 31, 2019 (index period for cohort identification); ≥1 migraine diagnosis on or 12 months prior to the index date (date of earliest fremanezumab claim); and continuous enrollment for 12 months before and after the index date. The study period was September 2017–March 2020. Patients were excluded from analysis if they were pregnant during the study period.

2,354 eligible patients with migraine were identified. Most patients had episodic migraine (54%) and were female (86%); mean[SD] age was 45.4[11.6] years. The proportion of patients using triptans decreased significantly from 12 months pre-initiation (pre-index) to 12 months post-initiation (post-index) of fremanezumab (69.2% to 61.8%; P<0.0001). Reductions were also seen in proportions of patients using NSAIDs (54.1% to 50.0%), opioids (42.9% to 40.5%), and ergots (4.5% to 3.2%; all P<0.05). From pre-index to post-index, mean[SD] annual number of total claims decreased from 10.6[10.7] to 9.3[10.5] for migraine-related prescription acute medications, from 4.9[6.4] to 4.0[5.7] for triptans, from 2.0[3.3] to 1.9[3.4] for NSAIDs, and from 2.6[5.9] to 2.5[5.7] for opioids (all P<0.05); the mean number of claims did not change significantly for ergots (0.1[0.7] and 0.1[0.9]; P=0.3713).

Fremanezumab treatment was associated with statistically significant reductions in acute medication use during 12 months post- versus 12 months pre-initiation.