From the Mayo Clinic (J.V., D.W.D.), Phoenix, AZ; Montefiore Headache Center (R.B.L.), Albert Einstein College of Medicine, New York, NY; Teva Pharmaceuticals Ltd (Y.M., P.S.L.), Netanya, Israel; and Teva Pharmaceuticals Ltd (M.E.B.), Frazer, PA. Dr. Bigal is now at Purdue Pharma, Stamford, CT.
Neurology. 2018 Sep 18;91(12):e1152-e1165. doi: 10.1212/01.wnl.0000544321.19316.40. Epub 2018 Aug 17.
To evaluate the effect of fremanezumab on the functional status on headache-free days in phase 2 episodic migraine (EM) and chronic migraine (CM) studies.
Functional status data were collected prospectively via the electronic headache diary on all headache-free days by patients answering questions regarding work/school/household chore performance, speed of work completion, concentration, and feeling of fatigue. Individuals with EM receiving monthly doses of fremanezumab 225 mg (n = 96) or 675 mg (n = 97) or placebo (n = 104) were compared. Individuals with CM receiving fremanezumab 675 mg followed by monthly 225 mg (n = 88) and 900 mg (n = 86) were also independently compared to those receiving placebo (n = 89).
In patients with EM, compared to patients receiving placebo, those receiving fremanezumab experienced an increased number of headache-free days with normal function in work/school/household chore performance and concentration/mental fatigue measures compared to their baseline over the entire treatment period (all < 0.005). An increased number of headache-free days with normal functional performance for some measures was also found in the CM group in those treated with fremanezumab.
There was an increased number of headache-free days with normal functional performance on all measures for the patients with EM and some measures for patients with CM in the fremanezumab-treated groups. Further research is required to confirm these findings in a prospective study and to clarify the underlying mechanism(s).
NCT02025556 and NCT02021773.
This study provides Class II evidence that for patients with migraine, fremanezumab increases normal functional performance on headache-free days.
评估在 2 期发作性偏头痛(EM)和慢性偏头痛(CM)研究中,依洛尤单抗对无头痛日功能状态的影响。
通过电子头痛日记前瞻性收集所有无头痛日的功能状态数据,患者回答关于工作/学校/家务表现、工作完成速度、注意力和疲劳感的问题。每月接受依洛尤单抗 225mg(n=96)或 675mg(n=97)或安慰剂(n=104)治疗的 EM 患者,每月接受依洛尤单抗 675mg 随后每月接受 225mg(n=88)和 900mg(n=86)治疗的 CM 患者,分别与接受安慰剂的患者(n=89)进行比较。
与接受安慰剂的患者相比,在 EM 患者中,与基线相比,在整个治疗期间,接受依洛尤单抗治疗的患者在工作/学校/家务表现和注意力/精神疲劳测量方面,无头痛日且功能正常的天数增加(均<0.005)。在接受依洛尤单抗治疗的 CM 患者中,某些测量指标的无头痛日且功能正常的天数也有所增加。
在 EM 患者中,依洛尤单抗治疗组的所有测量指标和 CM 患者的一些测量指标的无头痛日且功能正常的天数均有所增加。需要进一步的研究在前瞻性研究中确认这些发现,并阐明潜在的机制。
NCT02025556 和 NCT02021773。
本研究提供了 II 级证据,表明对于偏头痛患者,依洛尤单抗可提高无头痛日的正常功能表现。