OBJECTIVE

Fremanezumab, a fully humanized monoclonal antibody (IgG2Δa) that selectively targets calcitonin gene-related peptide (CGRP), is approved for preventive treatment of migraine in adults. A prior database study found claims for acute medication were reduced 6 months post-initiation of fremanezumab versus 6 months pre-initiation. Twelve-month post-initiation data are now available. Changes in acute medication use in the 12 months prior to fremanezumab initiation and during a 12-month follow-up period were retrospectively analyzed.

METHODS:

Eligible adults (≥18 years) identified from the IBM Marketscan Commercial and Medicare database (index period for cohort identification: September 1, 2018–March 31, 2019) included patients with ≥1 pharmacy claim for fremanezumab, ≥1 migraine diagnosis on or 12 months prior to the index date (date of earliest fremanezumab claim), and continuous enrollment for 12 months before (pre-index) and after index (post-index). The study period was September 2017–March 2020. Patients were not eligible if pregnant during the study period.

RESULTS:

Of the eligible patients (n=2,354) identified, the majority were female (86%) and had episodic migraine (54%); the mean (standard deviation, [SD]) age was 45.4 (11.6) years. Significant 12-month pre-index to 12-month post-index acute medication use reductions were observed in the proportion of patients using triptans (69.2% to 61.8%; P<0.0001), NSAIDs (54.1% to 50.0%; P=0.0003), opioids (42.9% to 40.5%; P=0.0333), and ergots (4.5% to 3.2%; P=0.0033). Significant reductions were also seen in mean (SD) annual numbers of total claims for migraine-related acute medication prescriptions (10.6 [10.7] to 9.3 [10.5]), triptans (4.9 [6.4] to 4.0 [5.7]), NSAIDs (2.0 [3.3] to 1.9 [3.4]), and opioids (2.6 [5.9] to 2.5 [5.7]; all P<0.05), except for ergots (0.1 [0.7] to 0.1 [0.9]; P=0.3713).

CONCLUSION

Fremanezumab treatment was associated with statistically significant reductions in acute medication use from 12 months pre-index to 12 months post-index.