New Drug Shows Promise for Episodic Migraine

The monoclonal antibody fremanezumab may be a viable treatment option for individuals with episodic migraine, according to new research.

This finding emerged from a study of 875 participants aged 18 to 70 years with episodic migraine—defined as 6 to 14 headache days, with at least 4 migraine days, during a 28-day pretreatment period.
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Participants were randomly assigned to a fremanezumab regimen or placebo. Fremanezumab regimens included subcutaneous monthly dosing of 225 mg at baseline and weeks 4 and 8 (n = 290) or a single higher dose of fremanizumab (675 mg at baseline; placebo at weeks 4 and 8), as intended to support a quarterly dose regimen. Placebo was administered at baseline and weeks 4 and 8 (n = 294).

Results of the study showed that mean migraine days per month decreased from 8.9 days to 4.9 days in the fremanezumab monthly dosing group, from 9.2 days to 5.3 days in the fremanezumab single-higher-dose group, and from 9.1 days to 6.5 days in the placebo group.

“Among patients with episodic migraine in whom multiple medication classes had not previously failed, subcutaneous fremanezumab, compared with placebo, resulted in a statistically significant 1.3- to 1.5-day reduction in the mean number of monthly migraine days over a 12-week period,” the researchers wrote.

“Further research is needed to assess effectiveness against other preventive medications and in patients in whom multiple preventive drug classes have failed and to determine long-term safety and efficacy,” they added.

The most commonly reported adverse events that led to treatment discontinuation included injection site erythema, injection site induration, diarrhea, anxiety, and depression.

—Christina Vogt

Reference:

Dodick DW, Silberstein SD, Bigal ME, et al. Effect of fremanezumab compared with placebo for prevention of episodic migraine: a randomized clinical trial. JAMA. 2018;319(19):1999-2008. doi:10.1001/jama.2018.4853