Early and sustained efficacy of fremanezumab over 24-weeks in migraine patients with multiple preventive treatment failures: the multicenter, prospective, real-life FRIEND2 study.


Journal

The journal of headache and pain
ISSN: 1129-2377
Titre abrégé: J Headache Pain
Pays: England
ID NLM: 100940562

Informations de publication

Date de publication:
23 Mar 2023
Historique:
received: 16 01 2023
accepted: 06 03 2023
entrez: 23 3 2023
pubmed: 24 3 2023
medline: 25 3 2023
Statut: epublish

Résumé

To verify the long-term (24-week) efficacy, safety, and tolerability of fremanezumab in real-life patients with high-frequency episodic migraine (HFEM: ≥ 8 days/month) or chronic migraine (CM: ≥ 15 days/month), and multiple preventive treatment failures. This is a prospective, cohort, real-life study at 28 headache centers on consecutive patients affected by HFEM or CM with multiple preventive treatment failures who were prescribed subcutaneous fremanezumab (225 mg monthly/675 mg quarterly) for ≥ 24 weeks. Primary endpoint was the change in monthly migraine days (MMDs) in HFEM and monthly headache days (MHDs) in CM at weeks 21-24 compared to baseline. Secondary endpoints encompassed changes in monthly analgesic medications, ≥ 50%, ≥ 75%, and 100% responder rates, and variation in NRS, HIT-6 and MIDAS scores at the same time interval. Changes in MMDs/MHDs, monthly analgesic medications, ≥ 50%, ≥ 75%, and 100% responder rates, and variation in NRS and HIT-6 scores at week 4 were also monitored. Four hundred ten patients who had received ≥ 1 dose of fremanezumab were considered for safety analysis while 148 patients treated for ≥ 24 weeks were included in the efficacy analysis. At weeks 21-24, fremanezumab significantly (p < 0.001) reduced MMDs, MHDs, monthly analgesic medications and NRS, HIT-6, and MIDAS scores in both HFEM and CM compared to baseline. The proportions of ≥ 50%, ≥ 75% and 100% responders at weeks 21-24were 75.0%, 30.8%, 9.6% (HFEM), and 72.9, 44.8 and 1% (CM). A significant (p < 0.001) decrease in MMDs, MHDs, monthly analgesic medications and NRS, HIT-6, and MIDAS scores in both HFEM and CM was already present at week 4. The proportions of ≥ 50%, ≥ 75%, and 100% responders at week 4 were 67.6%, 32.4%, 11.8% (HFEM) and 67.3%, 40%, 1.8% (CM). CM remitted to episodic migraine and medication overuse to no-medication overuse in 83.3 and 75% of patients at week 24, and in 80 and 72.4% at week 4. Adverse events were rare (2.4%), mild and transient. No patient discontinued treatment for any reason. Fremanezumab is characterized by an early and sustained efficacy in HFEM and CM patients with multiple preventive treatment failures in real-life, revealing an optimal safety and tolerability profile.

Sections du résumé

BACKGROUND BACKGROUND
To verify the long-term (24-week) efficacy, safety, and tolerability of fremanezumab in real-life patients with high-frequency episodic migraine (HFEM: ≥ 8 days/month) or chronic migraine (CM: ≥ 15 days/month), and multiple preventive treatment failures.
METHODS METHODS
This is a prospective, cohort, real-life study at 28 headache centers on consecutive patients affected by HFEM or CM with multiple preventive treatment failures who were prescribed subcutaneous fremanezumab (225 mg monthly/675 mg quarterly) for ≥ 24 weeks. Primary endpoint was the change in monthly migraine days (MMDs) in HFEM and monthly headache days (MHDs) in CM at weeks 21-24 compared to baseline. Secondary endpoints encompassed changes in monthly analgesic medications, ≥ 50%, ≥ 75%, and 100% responder rates, and variation in NRS, HIT-6 and MIDAS scores at the same time interval. Changes in MMDs/MHDs, monthly analgesic medications, ≥ 50%, ≥ 75%, and 100% responder rates, and variation in NRS and HIT-6 scores at week 4 were also monitored.
RESULTS RESULTS
Four hundred ten patients who had received ≥ 1 dose of fremanezumab were considered for safety analysis while 148 patients treated for ≥ 24 weeks were included in the efficacy analysis. At weeks 21-24, fremanezumab significantly (p < 0.001) reduced MMDs, MHDs, monthly analgesic medications and NRS, HIT-6, and MIDAS scores in both HFEM and CM compared to baseline. The proportions of ≥ 50%, ≥ 75% and 100% responders at weeks 21-24were 75.0%, 30.8%, 9.6% (HFEM), and 72.9, 44.8 and 1% (CM). A significant (p < 0.001) decrease in MMDs, MHDs, monthly analgesic medications and NRS, HIT-6, and MIDAS scores in both HFEM and CM was already present at week 4. The proportions of ≥ 50%, ≥ 75%, and 100% responders at week 4 were 67.6%, 32.4%, 11.8% (HFEM) and 67.3%, 40%, 1.8% (CM). CM remitted to episodic migraine and medication overuse to no-medication overuse in 83.3 and 75% of patients at week 24, and in 80 and 72.4% at week 4. Adverse events were rare (2.4%), mild and transient. No patient discontinued treatment for any reason.
CONCLUSIONS CONCLUSIONS
Fremanezumab is characterized by an early and sustained efficacy in HFEM and CM patients with multiple preventive treatment failures in real-life, revealing an optimal safety and tolerability profile.

Identifiants

pubmed: 36949388
doi: 10.1186/s10194-023-01561-w
pii: 10.1186/s10194-023-01561-w
pmc: PMC10035286
doi:

Substances chimiques

fremanezumab 0

Types de publication

Multicenter Study Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

30

Investigateurs

Maria Albanese (M)
Marco Bertolini (M)
Davide Bertuzzo (D)
Maria Bloise (M)
Francesco Bono (F)
Laura Borrello (L)
Cecilia Camarda (C)
Giulia Fiorentini (G)
Licia Grazzi (L)
Domenica Le Pera (D)
Roberta Messina (R)
Pietro Querzani (P)
Antonio Salerno (A)
Silvia Strumia (S)
Alessandro Valenza (A)
Fabrizio Vernieri (F)
Giovanna Viticchi (G)

Informations de copyright

© 2023. The Author(s).

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Auteurs

Piero Barbanti (P)

Headache and Pain Unit, IRCCS San Raffaele Roma, Via Della Pisana 235, 00163, Rome, Italy. piero.barbanti@sanraffaele.it.
San Raffaele University, Rome, Italy. piero.barbanti@sanraffaele.it.

Gabriella Egeo (G)

Headache and Pain Unit, IRCCS San Raffaele Roma, Via Della Pisana 235, 00163, Rome, Italy.

Cinzia Aurilia (C)

Headache and Pain Unit, IRCCS San Raffaele Roma, Via Della Pisana 235, 00163, Rome, Italy.

Paola Torelli (P)

Department of Medicine and Surgery, Headache Center, Neurology Unit, University of Parma, Parma, Italy.

Cinzia Finocchi (C)

Neurology Unit, San Paolo Hospital, ASL 2, Savona, Italy.

Florindo d'Onofrio (F)

Neurology Unit, San Giuseppe Moscati Hospital, Avellino, Italy.

Luigi d'Onofrio (L)

Campus Bio-Medico University Hospital, Rome, Italy.

Renata Rao (R)

Department of Vision and Neurological Sciences, Spedali Civili, Brescia, Italy.

Stefano Messina (S)

Department of Neurology-Stroke Unit, Laboratory of Neuroscience, Istituto Auxologico Italiano, IRCCS, Milano, Italy.

Laura Di Clemente (L)

Headache Center, Neurology Unit, San Camillo-Forlanini Hospital, Rome, Italy.

Angelo Ranieri (A)

Neurology Unit and Stroke-Unit, AORN A. Cardarelli, Naples, Italy.

Massimo Autunno (M)

Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy.

Giuliano Sette (G)

Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), "Sapienza" University of Rome, Sant'Andrea University Hospital, Rome, Italy.

Bruno Colombo (B)

Department of Neurology, Headache Unit, Scientific Institute San Raffaele Hospital, Vita-Salute University, Milan, Italy.

Antonio Carnevale (A)

Headache Center, Neurology Unit, San Filippo Neri Hospital, Rome, Italy.

Marco Aguggia (M)

Neurology and Stroke Unit, Cardinal Massaia Hospital, Asti, Italy.

Miriam Tasillo (M)

Stroke Unit, S. Camillo de Lellis Hospital, Rieti, Italy.

Francesco Zoroddu (F)

Pediatric Headache Center, Neurology Unit, University of Sassari, Sassari, Italy.

Fabio Frediani (F)

Headache Center, ASST Santi Paolo Carlo, Milan, Italy.

Massimo Filippi (M)

Department of Neurology, Headache Unit, Scientific Institute San Raffaele Hospital, Vita-Salute University, Milan, Italy.

Carlo Tomino (C)

Headache and Pain Unit, IRCCS San Raffaele Roma, Via Della Pisana 235, 00163, Rome, Italy.

Stefania Proietti (S)

Clinical and Molecular Epidemiology, IRCCS San Raffaele Roma, Rome, Italy.

Stefano Bonassi (S)

Clinical and Molecular Epidemiology, IRCCS San Raffaele Roma, Rome, Italy.
Department of Human Sciences and Quality of Life Promotion, San Raffaele University, Rome, Italy.

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