PND109 Improvements in Patient-Reported Migraine PAIN Intensity and Composite Migraine Symptoms with Fremanezumab in the Real World
McAllister P, Lamerato L, Casciano J, Cohen JM, Thompson S, Krasenbaum L, Dotiwala Z, Tangirala K, and Mauskop A. PND109 Improvements in Patient-Reported Migraine PAIN Intensity and Composite Migraine Symptoms with Fremanezumab in the Real World. Value in Health 2020; 23:S642.
Value in Health
Objectives: Fremanezumab, a fully-humanized monoclonal antibody (IgG2Δa) that selectively targets the calcitonin gene-related peptide (CGRP) pathway, has been approved for migraine prevention in adults with episodic migraine (EM) or chronic migraine (CM). However, little data exists on the effectiveness of fremanezumab in a real-world setting. This retrospective, observational cohort study assessed real-world patient-reported changes in migraine pain intensity (MPI) and composite migraine symptoms (headache frequency/symptoms) after starting fremanezumab therapy. Methods: Data were extracted from September 2018 through June 2020 from the Midwest component of EMRClaims+®, an integrated health services database containing >20 million medical records from national commercial insurance claims, Medicare claims, and regional electronic medical records. Patients included were aged ≥18 years and were administered fremanezumab, with enrollment or treatment history ≥6 months prior to initiating fremanezumab (index date) and enrollment or treatment encounter ≥1 month after the index date. MPI (10-point visual analog scale [VAS; 0=no pain, 10=worst pain]) and patient-reported change in headache frequency/symptoms were assessed pre-index and ≥1 month after fremanezumab initiation. Wilcoxon signed-rank tests were used to compare MPI and headache frequency/symptoms before and after fremanezumab initiation. Results: Seventy-four patients (EM, n=21; CM, n=49) were eligible for analysis of MPI. MPI decreased significantly by 18% after fremanezumab initiation in the overall population: mean (standard deviation [SD]) VAS pain score was 5.47 (3.19) pre-index versus 4.51 (3.34) post-index (P=0.014). After fremanezumab initiation, pain levels decreased significantly by 45% in patients with EM (mean [SD] VAS pain score: pre-index, 5.57 [3.56]; post-index, 3.04 [3.37]; P=0.002) and decreased non-significantly by 10% in patients with CM after fremanezumab initiation (pre-index, 5.61 [2.99]; post-index, 5.06 [3.16]; P=0.203). Among patients who self-reported changes in headache frequency/symptoms (n=129), 83.7% reported improvement after fremanezumab initiation. Conclusions: After fremanezumab initiation, MPI decreased significantly and the majority of patients reported an improvement in headache frequency/symptoms.