EHC 2022 | Switching erenumab to fremanezumab in chronic migraine: results of a real-world study
Valeria Caponnetto, PhD, MSN, RN, University of L’Aquila, Avezzano, Italy, discusses a real-world study that investigated if a monoclonal antibody (mAb) against circulating CGRP is effective in chronic migraine patients who did not respond at all or sufficiently to a mAb against CGRP receptor. The preliminary results showed that 24.2% of chronic migraine patients who fail to respond to erenumab could respond to fremanezumab. Furthermore, a small proportion of patients who did not respond to fremanezumab at month 3 but continued to month 6, became responders, increasing the overall percentage of responders to 30.3% after 6 months of treatment. These findings suggest that switching from a mAb against CGRP receptor to a mAb against circulating CGRP could be a potential strategy for a subgroup of otherwise refractory patients. This interview took place at the 16th European Headache Congress (EHC) in Vienna, Austria.
These works are owned by Magdalen Medical Publishing (MMP) and are protected by copyright laws and treaties around the world. All rights are reserved.
Transcript (edited for clarity)
We performed this audit study at St. Thomas’ Hospital and where I was an observer, and since we know that up to 60% of patients treated with the monoclonal antibodies may not have a brilliant response to this drug, we wonder whether switching them to a ligand anti-CGRP monoclonal antibody could improve their response. And we perform this in clinical practice. So we decided to observe the result of this switch...
We performed this audit study at St. Thomas’ Hospital and where I was an observer, and since we know that up to 60% of patients treated with the monoclonal antibodies may not have a brilliant response to this drug, we wonder whether switching them to a ligand anti-CGRP monoclonal antibody could improve their response. And we perform this in clinical practice. So we decided to observe the result of this switch. And we saw that up to 30% of our patients actually were responders to fremanezumab even if they didn’t respond brilliantly to erenumab.
About implications, we can think for the future to use a ligand anti-CGRP monoclonal antibody for patients that could be considered as refractory. So that didn’t respond also to a monoclonal antibody directed to the receptor. And this could be another option in an otherwise refractory group of patients.
Read more...
