Yoshida Shohei, Imai Noboru, Keicho Masato, Kamimura Jun, Moriya Asami, Yagi Nobuyasu, Suzuki Rieko, Konishi Takashi, Serizawa Masahiro
Japanese Red Cross Society Shizuoka Hospital, Shizuoka, Japan.
J Headache Pain. 2025 Mar 11;26(1):51. doi: 10.1186/s10194-025-01994-5.
Real-world data on the long-term adherence to- and efficacy of fremanezumab 675 mg quarterly dosing remain scarce. Our study evaluated the efficacy of- and patient adherence to 675 mg fremanezumab for episodic migraine (EM) and chronic migraine (CM) over 2 years and analyzed the reasons for discontinuation.
Among patients attending our headache outpatient clinic, those aged ≥ 15 years who commenced fremanezumab 675 mg quarterly dose schedule from November 2021 to June 2022 were enrolled in this single-center observational study. The frequency and severity of headaches were recorded using a headache diary. The observation period ended for each patient at 24 months after treatment initiation. The reasons for discontinuation were documented based on follow-up medical records.
Twenty-eight patients were enrolled, of whom 15 had CM and 13 had EM. One patient with CM was excluded due to withdrawal after the first injection. Of the 27 remaining patients, the treatment was effective in 70.4% (n = 19). 44.4% (n = 12) continued fremanezumab 675 mg until study termination. Among those patients who remained on fremanezumab for two years, seven updated the monthly headache calendars consistently: 2 had CM, and 5 had EM. Mean changes in MMD from the baseline were - 2.2 at 3 months,, -1.8 at 12 months, and - 1.6 (SD = 3.0) at 2 years. Treatment was discontinued because of sustained improvement in 25.9% (n = 7). 22.2% of cases (n = 6) experienced insufficient effectiveness, resulting in discontinuation. One patient (3.7%) discontinued because of injection-site erythema. One patient (3.7%) was discontinued because of pregnancy. Among the non-responders, three switched from fremanezumab to erenumab, with one returning to fremanezumab at a monthly injection of 225 mg after efficacy with erenumab waned. Two patients switched to galcanezumab. All patients who switched medication continued the new medication owing to its effectiveness. One patient was lost to follow-up.
Fremanezumab 675 mg quarterly dose effectively reduces headache frequency over an extended period and may facilitate medication cessation in patients who experience substantial recovery.
关于每季度注射675毫克夫瑞内祖单抗的长期依从性和疗效的真实世界数据仍然稀缺。我们的研究评估了675毫克夫瑞内祖单抗治疗发作性偏头痛（EM）和慢性偏头痛（CM）超过2年的疗效及患者依从性，并分析了停药原因。
在我们头痛门诊就诊的患者中，年龄≥15岁且于2021年11月至2022年6月开始每季度注射675毫克夫瑞内祖单抗的患者被纳入这项单中心观察性研究。使用头痛日记记录头痛的频率和严重程度。每位患者的观察期在治疗开始后24个月结束。根据随访病历记录停药原因。
共纳入28例患者，其中15例为CM，13例为EM。1例CM患者因首次注射后退出而被排除。在其余27例患者中，治疗有效的占70.4%（n = 19）。44.4%（n = 12）持续使用675毫克夫瑞内祖单抗直至研究结束。在持续使用夫瑞内祖单抗两年的患者中，7例持续更新每月头痛日历：2例为CM，5例为EM。从基线开始，3个月时每月偏头痛天数（MMD）的平均变化为-2.2，12个月时为-1.8，2年时为-1.6（标准差 = 3.0）。25.9%（n = 7）因症状持续改善而停药。22.2%的病例（n = 6）因疗效不佳而停药。1例患者（3.7%）因注射部位红斑停药。1例患者（3.7%）因怀孕停药。在无反应者中，3例从夫瑞内祖单抗换用erenumab，其中1例在erenumab疗效减弱后每月注射225毫克夫瑞内祖单抗后又重新使用该药。2例患者换用加卡尼单抗。所有换药的患者因新药有效而继续使用。1例患者失访。
每季度注射675毫克夫瑞内祖单抗可有效长期降低头痛频率，并可能有助于症状大幅缓解的患者停药。
