Tolerability of switch from erenumab to fremanezumab in adults with chronic migraine: a 3-month, single-center, prospective, real-world, observational study.

OBJECTIVE

While erenumab and fremanezumab are effective treatments for migraine prevention, it is unclear whether patients who experience adverse events related to erenumab can tolerate fremanezumab. This study evaluated the tolerability of switching from erenumab to fremanezumab in patients with chronic migraine who experienced adverse events on erenumab.

METHODS

Data was obtained from adult patients with chronic migraine who failed erenumab treatment due to lack of tolerability and subsequently received at least three months of treatment with fremanezumab after discontinuing erenumab. Adverse events were recorded before and after the switch.

RESULTS

In total, 94 patients were enrolled, with a median age of 50 years. Hereof, 29 (31%) participants experienced treatment-emergent adverse events during the study period after switching from erenumab to fremanezumab. The most prevalent adverse event on erenumab before switching was constipation ( = 74, 79%), which reduced to only 12% ( = 9) of patients who switched to fremanezumab. There was no treatment discontinuation after switching to fremanezumab during the three-months study period.

CONCLUSION

Switching treatment from erenumab to fremanezumab due to adverse events is well-tolerated in patients with chronic migraine. This findings suggests a viable option to switch between treatments. Further studies are needed to assess the efficacy of switching between these treatments.