AHS 2022 | Assessing the efficacy of fremanezumab on interictal migraine related burden

At the 2022 American Headache Society (AHS) Meeting, various studies were presented that have implications for neurologists in the US and internationally. Stewart Tepper, MD, Dartmouth-Hitchcock Medical Center, discusses a study that evaluated the effects of the anti-CGRP ligand monoclonal antibody fremanezumab in patients with migraine. The objective was to assess if a reduction in mean monthly migraine days is necessary to evaluate clinical benefit. Many countries in the EU have requirements whereby if a patient does not reach a fixed percentage of reduction of monthly migraine days by certain time points, they are taken off the anti-CGRP therapies. In this study, the investigators established the baseline in mean monthly migraine days, comparing the patients who had a 50% reduction at three months to non-responder patients – measuring a variety of important outcomes associated with quality of life and function. These included the Migraine Interictal Burden Scale (MIBS-4), Neuro-QoL Sleep Disturbance Short Form, General Self Efficacy Short Form, Patient-Reported Outcomes Measurement Information System (PROMIS-29), Work Productivity and Impairment-Migraine (WPAI-M), and the Brief Measure of Worry Severity (BMWS). The results demonstrated that regardless of the reduction in mean monthly migraine days, there was a drastic reduction in interictal burden with an improved quality of life across various measures – suggesting that many regulatory authorities should change how they evaluate the effectiveness of these drugs. This interview took place at the 2022 AHS Meeting in Denver, CO.