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.

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.

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.

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]).

Approximately 37% of the patients with migraine who switched to fremanezumab experienced significant reductions in MMDs and acute migraine medication use. For patients experiencing poor tolerability or effectiveness to other CGRP pathway targeted therapies, switching to fremanezumab may be an option.

Material from: Straube A, et al. Schmerz 2022, Springer Medizin (Suppl 1):S35. https://doi.org/10.1007/s00482-022-00667-5 reproduced with permission of SNCSC