To evaluate real-world patient-reported changes in migraine pain intensity (MPI) and headache frequency/symptoms after fremanezumab treatment initiation.

Fremanezumab, a fully-humanized monoclonal antibody (IgG2Δa) that selectively targets calcitonin gene-related peptide (CGRP), has been approved for migraine prevention in adults with episodic migraine (EM) or chronic migraine (CM). However, little data exists on the effectiveness of fremanezumab in a real-world setting.

In this retrospective, observational cohort study, data were extracted from September 2018 through June 2020 from the Midwest component of EMRClaims+^®, an integrated health services database containing >20 million medical records from national commercial insurance claims, Medicare claims, and regional electronic medical records. Patients aged ≥18 years were administered fremanezumab, with enrollment or treatment history ≥6 months prior to initiating fremanezumab (index date) and enrollment or treatment encounter ≥1 month after the index date. MPI (10-point visual analog scale [VAS; 0=no pain, 10=worst pain]) and patient-reported change in headache frequency/symptoms were assessed pre-index and ≥1 month after fremanezumab initiation. Wilcoxon signed-rank tests were used to compare MPI and headache frequency/symptoms before and after fremanezumab initiation.

Overall, 74 patients (EM, n=21; CM, n=49) were eligible for analysis of MPI. MPI decreased significantly by 18% after fremanezumab initiation in the overall population: mean (standard deviation [SD]) VAS pain score was 5.47 (3.19) pre-index versus 4.51 (3.34) post-index (P=0.014). After fremanezumab initiation, pain levels decreased significantly by 45% in patients with EM (mean [SD] VAS pain score: pre-index, 5.57 [3.56]; post-index, 3.04 [3.37]; P=0.002) and decreased non-significantly by 10% in patients with CM after fremanezumab initiation (pre-index, 5.61 [2.99]; post-index, 5.06 [3.16]; P=0.203). In addition, 83.7% of patients who self-reported changes in headache frequency/symptoms reported improvement after fremanezumab initiation.

After fremanezumab initiation, MPI decreased significantly and the majority of patients reported an improvement in headache frequency/symptoms.