Neuropsychiatric Disease and Treatment (Feb 2023)
Review of Tolerability of Fremanezumab for Episodic and Chronic Migraine
Abstract
Shane Root,1– 3 Kevin Ahn,3 Jack Kirsch,3 Justin L Hoskin1– 3 1Department of Neurology, Barrow Neurological Institute, Phoenix, AZ, USA; 2University of Arizona School of Medicine, Phoenix, AZ, USA; 3Creighton University School of Medicine, Omaha, NE, USACorrespondence: Shane Root, Department of Neurology, Barrow Neurological Institute, 240 West Thomas Road Suite 400, Phoenix, AZ, 85013, USA, Tel +1 602 406 6262, Email [email protected]: Calcitonin gene-related peptide (CGRP) monoclonal antibodies (mAbs) were the first class of medication specifically developed for the prevention of migraine. Fremanezumab is one of four CGRP mAbs currently available and is approved by the US Food and Drug Administration (FDA) for the preventative treatment of episodic and chronic migraines. This narrative review summarizes the history of fremanezumab development, the trials that led to its approval, and the later studies published evaluating its tolerability and efficacy. Evidence of fremanezumab for clinically significant efficacy and tolerability in patients with chronic migraine is especially important when considering the high level of disability, lower quality of life scores, and higher levels of health-care utilization associated with this condition. Multiple clinical trials demonstrated superiority of fremanezumab over placebo in terms of efficacy while demonstrating good tolerability. Treatment-related adverse reactions did not differ significantly compared to placebo and dropout rates were minimal. The most commonly observed treatment-related adverse reaction was mild-to-moderate injection site reaction, described as erythema, pain, induration, or swelling at the injection site.Keywords: calcitonin gene related peptide, CGRP, monoclonal antibodies, mAbs, chronic migraine
