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

Autor: Straube A; Department of Neurology, University Hospital, LMU Munich, Munich, Germany. Andreas.Straube@med.uni-muenchen.de., Broessner G; Department of Neurology, Innsbruck Medical University, Innsbruck, Austria., Gaul C; Headache Center Frankfurt, Frankfurt, Germany., Hamann X; Teva GmbH, Ulm, Germany., Hipp J; Teva GmbH, Ulm, Germany., Kraya T; Department of Neurology, Hospital Sankt Georg Leipzig gGmbH, Leipzig, Germany.; Department of Neurology, Headache Center Halle, University Hospital Halle, Halle (Saale), Germany., Neeb L; Helios Global Health, Berlin, Germany.; Department of Neurology, Charité-Universitätsmedizin Berlin, Berlin, Germany.
Jazyk: angličtina
Zdroj: The journal of headache and pain [J Headache Pain] 2023 May 23; Vol. 24 (1), pp. 59. Date of Electronic Publication: 2023 May 23.
DOI: 10.1186/s10194-023-01593-2
Abstrakt: Background: Monoclonal 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).
Methods: FINESSE, 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.
Results: One 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).
Conclusions: Our 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 Registration: FINESSE Study is registered on the European Network of Centres for Pharmacoepidemiology and Pharmacovigilance (EUPAS44606).
(© 2023. The Author(s).)
Databáze: MEDLINE
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