Migraine headache is a common, chronic, debilitating disease with a complex etiology. Current therapy for migraine headache comprises either treatments targeting acute migraine pain or prophylactic therapy aimed at increasing the length of time between migraine episodes. Recent evidence suggests that calcium gene-related peptide (CGRP) is a critical component in the pathogenesis of migraines. Fremanezumab, a monoclonal antibody against CGRP, was recently approved by the Food and Drug Administration (FDA) after multiple studies showed that it was well-tolerated, safe, and effective in the treatment of migraines. Further research is needed to elucidate the long-term effects of fremanezumab and CGRP-antagonists in general, and additional data is required in less healthy patients to estimate its effects in these populations and potentially increase the eligible group of recipients. This is a comprehensive review of the current literature on the efficacy and safety of fremanezumab for the treatment of chronic migraine. In this review we provide an update on the epidemiology, pathogenesis, diagnosis, and current treatment of migraine, and summarize the evidence for fremanezumab as a treatment for migraine.
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http://dx.doi.org/10.1007/s40122-020-00159-3 | DOI Listing |
Adv Ther
January 2025
Dent Neurologic Institute, 3980 Sheridan Dr., Amherst, NY, 14226, USA.
Introduction: Fremanezumab, a monoclonal antibody (mAb) targeting the calcitonin gene-related peptide (CGRP) pathway, and gepants, small molecule CGRP receptor antagonists, are both approved for the treatment of migraine or its symptoms. This study assessed effectiveness, tolerability, and migraine-related healthcare resource utilization (HCRU) after the addition of fremanezumab for preventive migraine treatment in patients using gepants for acute treatment.
Methods: Data were extracted during a retrospective chart review from electronic medical records from the Dent Neurologic Institute.
ARP Rheumatol
January 2025
ULS Gaia e Espinho.
Background: Case reports suggest that calcitonin gene-related peptide monoclonal antibodies (CGRP mAbs) may trigger inflammatory flares in patients with autoimmune diseases.
Case Description: A 56-year-old woman with a history of severe migraines, experienced improvement in migraine frequency and intensity after starting fremanezumab 225 mg monthly. However, three months into treatment, she developed symmetric inflammatory polyarthralgias.
Biosens Bioelectron
February 2025
Department of Materials Science and Engineering, Yonsei University, 50 Yonsei-Ro, Seodaemun-Gu, Seoul, Republic of Korea. Electronic address:
Migraine is known to be caused by calcitonin gene-related peptide (CGRP), prompting the need for quantitative analysis of CGRP for the clinical treatment of monoclonal antibodies targeting CGRP. Since CGRP is cleaved by proteolytic enzymes post-blood collection, rapid analysis methods are required. In this study, a one-step immunoassay for CGRP was developed using chemically mimicking peptides (mimotopes) with an analysis time of 32 min.
View Article and Find Full Text PDFEur J Neurol
January 2025
Department of Neurology, Leiden University Medical Centre, Leiden, The Netherlands.
Background And Purpose: Limited options exist for migraine prevention after stopping anti-calcitonin gene-related peptide monoclonal antibodies. A systematic review examining the benefits of switching between different classes (ligand vs. receptor monoclonal antibody) is essential, alongside well-designed real-world studies.
View Article and Find Full Text PDFCephalalgia
November 2024
Department of Neurology, Vall d'Hebron University Hospital, Barcelona, Spain.
Background: To evaluate the benefit-risk assessment of atogepant and calcitonin gene-related peptide (CGRP) monoclonal antibodies (mAbs) vs. placebo based on the number needed to treat (NNT) and the number needed to harm (NNH) in a blended episodic migraine and chronic migraine (EM + CM) population.
Methods: The NNT was calculated based on achievement of a ≥ 50% reduction in mean monthly migraine days (MMDs) from baseline across 12 weeks.
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