Real-world effectiveness of fremanezumab in patients with migraine switching from another mAb targeting the CGRP pathway: a subgroup analysis of the Finesse Study

The Journal of Headache and Pain

Research

Torsten Kraya¹  Gregor Broessner²  Andreas Straube³  Charly Gaul⁴  Lars Neeb⁵  Xenia Hamann⁶  Joachim Hipp⁶ 

[1] Department of Neurology, Hospital Sankt Georg Leipzig gGmbH, Leipzig, Germany;Department of Neurology, Headache Center Halle, University Hospital Halle, Halle (Saale), Germany;Department of Neurology, Innsbruck Medical University, Innsbruck, Austria;Department of Neurology, University Hospital, LMU Munich, Munich, Germany;Headache Center Frankfurt, Frankfurt, Germany;Helios Global Health, Berlin, Germany;Department of Neurology, Charité-Universitätsmedizin Berlin, Berlin, Germany;Teva GmbH, Ulm, Germany;

关键词: Fremanezumab;    Calcitonin gene-related peptide;    Migraine;    Non-responder;   

DOI  :  10.1186/s10194-023-01593-2

 received in 2023-03-23, accepted in 2023-05-07,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundMonoclonal antibodies targeting the CGRP pathway are effective and safe for prophylactic treatment of episodic (EM) and chronic migraine (CM). In case of treatment failure of a CGRP pathway targeting mAb, physician has to decide whether using another anti-CGRP pathway mAb is useful. This interim analysis of Finesse Study evaluates effectiveness of the anti-CGRP mAb fremanezumab in patients with a history of other prior anti-CGRP pathway mAb treatments (switch patients).MethodsFinesse, a non-interventional, prospective, multicentre, two-country (Germany-Austria) study observing migraine patients receiving fremanezumab in clinical routine. This subgroup analysis presents data on documented effectiveness over 3 months after the first dose of fremanezumab in switch patients. Effectiveness was evaluated based on reduction in average number of migraine days per month (MMDs), MIDAS and HIT-6 scores changes as well as in number of monthly days with acute migraine medication use.ResultsOne hundred fifty-three out of 867 patients with a history of anti-CGRP pathway mAb treatment prior to initiation of fremanezumab were analysed. Switch to fremanezumab led to ≥ 50% MMD reduction in 42.8% of migraine patients, with higher response rate in EM (48.0%) than in CM patients (36.5%). A ≥ 30% MMD reduction was achieved by 58.7% in CM patients. After three months, monthly number of migraine days decreased by 6.4 ± 5.87 (baseline: 13.6 ± 6.5; p < 0.0001) in all patients, 5.2 ± 4.04 in EM and 7.7 ± 7.45 in CM patients. MIDAS scores decreased from 73.3 ± 56.8 (baseline) to 50.3 ± 52.9 (after 3 months; p = 0.0014), HIT-6 scores decreased from 65.9 ± 5.0 to 60.9 ± 7.2 (p < 0.0001). Concomitant use of acute migraine medication had decreased from 9.7 ± 4.98 (baseline) to 4.9 ± 3.66 (3 months) (p < 0.0001).ConclusionsOur results show that about 42.8% of anti-CGRP pathway mAb-non-responder benefit from switching to fremanezumab. These results suggest that switching to fremanezumab may be a promising option for patients experiencing poor tolerability or inadequate efficacy with prior other anti-CGRP pathway mAb use.Trial registrationFinesse Study is registered on the European Network of Centres for Pharmacoepidemiology and Pharmacovigilance (EUPAS44606).Graphical Abstract

【 授权许可】

CC BY   
© The Author(s) 2023

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