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Preventive Therapy for Chronic Migraine


Migraine is a complex neurologic disorder
characterized by recurrent attacks of headache of at least moderate severity. Chronic migraine, defined as the occurrence
of 15 or more headaches per month for 3 months, can lead to functional impairment and reduced
quality of life. Evidence of increased levels of calcitonin
gene-related peptide, or CGRP, has been found in migraine patients. Fremanezumab is a humanized monoclonal antibody
that targets CGRP and has been investigated as a preventive
treatment for chronic migraine. In this phase 3 randomized, double-blind,
placebo-controlled, parallel-group trial, investigators randomized 1130 eligible patients
to receive a single subcutaneous injection of fremanezumab at baseline, fremanezumab at baseline and weeks 4 and 8, or placebo during a 12-week treatment period. The primary endpoint was the mean change in
the monthly average number of headache days of at least moderate severity during the 12
weeks after the first dose. Fremanezumab resulted in a reduction from
baseline of 4.3 headache days with single-dose treatment and 4.6 headache days with monthly
treatment, as compared with 2.5 headache days with placebo, resulting in a statistically
significant difference between treatment groups and placebo. In addition, 38% of the patients receiving
a single dose of fremanezumab, 41% of those taking fremanezumab monthly, and
18% of the patients taking placebo had a reduction of 50% or more from
baseline in headache days of at least moderate severity at 12 weeks. The most common adverse event was injection
site pain, which occurred in 30% of patients in the single dose group, 26% in the monthly
group and 28% in the placebo group. The authors conclude that fremanezumab, given
as a single dose or monthly as subcutaneous injection, is effective over a period of 12 weeks as preventive treatment for patients with chronic migraine. Full trial results are available at NEJM.org

3 Comments

  1. Medicina en Video
    Medicina en Video November 30, 2017

    Un nuevo artículo para leer!

  2. Matharage Prasad
    Matharage Prasad February 20, 2018

    Brilliant! Thank you!

  3. Der Mexikaner
    Der Mexikaner March 8, 2018

    I hope it works for post traumatic headache

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