Monthly versus quarterly fremanezumab for the prevention of migraine: a systemic review and meta-analysis from randomized controlled trials

Naunyn Schmiedebergs Arch Pharmacol. 2021 Apr;394(4):819-828. doi: 10.1007/s00210-020-02009-7. Epub 2020 Nov 2.

Abstract

Fremanezumab (TEV-48125) is a novel therapeutic drug for migraine prevention. Previous randomized controlled trials have proved the efficacy of fremanezumab; however, no systematic review has been performed to compare the differences between monthly and quarterly administration of fremanezumab. This meta-analysis aims to probe into the safety and efficacy of monthly fremanezumab for the prevention of migraine versus quarterly fremanezumab. We searched Pubmed, Embased, and Cochrane Library from December 1999 to December 2019 for randomized controlled trials (RCTs). Our meta-analysis finally pooled three RCTs with 1884 patients. We combined 1884 patients from three randomized controlled trials; the primary endpoint was mean monthly migraine days, from baseline to week 12. We concluded that the monthly administration of fremanezumab brought about a significant reduction in migraine days versus quarterly fremanezumab (P = 0.0008). Besides, monthly and quarterly fremanezumab have the same risk with mild and severe adverse events (P = 0.50; P = 0.39). Monthly administration of fremanezumab shows better outcomes for preventing migraines than quarterly fremanezumab and will not let to more adverse events. Patients with episodic migraine (EM) benefit more from monthly fremanezumab than patients with chronic migraine (CM).

Keywords: Chronic migraine; Episodic migraine; Fremanezumab; Meta-analysis; Monthly administration; Quarterly administration.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't
  • Systematic Review

MeSH terms

  • Antibodies, Monoclonal / administration & dosage*
  • Antibodies, Monoclonal / adverse effects
  • Calcitonin Gene-Related Peptide / antagonists & inhibitors*
  • Drug Administration Schedule
  • Humans
  • Migraine Disorders / prevention & control*
  • Randomized Controlled Trials as Topic

Substances

  • Antibodies, Monoclonal
  • fremanezumab
  • Calcitonin Gene-Related Peptide