Fremanezumab Brand Name– AJOVY
What is Fremanezumab
- Fremanezumab is an injectable calcitonin gene-related peptide (CGRP) receptor antagonist indicated for migraine prophylaxis in adults.
- In 3-month clinical trials of patients with episodic migraine, fremanezumab significantly reduced monthly migraine days in comparison to placebo; monthly migraine days were reduced by 3.7 days, 3.4 days, and 2.2 days for fremanezumab once monthly, once quarterly, and placebo, respectively, from a baseline of approximately 9 days/month for each group.
- At month 3, fremanezumab-treated chronic migraine patients experienced significant reductions in monthly migraine days of at least moderate severity of 4.6 days for monthly and 4.3 days for quarterly dosing from baselines of approximately 13 days/month vs. placebo.
- A 50% or greater reduction in monthly migraine days was achieved by 44.4% to 47.7% of episodic migraineurs and 37.6% to 40.8% of chronic migraineurs who were treated with fremanezumab compared to 27.9% of episodic migraineurs and 18.1% of chronic migraineurs given placebo
Indications
- migraine prophylaxis
Side Effects
- alopecia
- antibody formation
- constipation
- erythema
- injection site reaction
- pruritus
- rash
- urticaria
Monitoring Parameters
- laboratory monitoring not necessary
Contraindications
- breast-feeding
- pregnancy
Interactions
There are no drug interactions associated with Fremanezumab products.
Mechanism of Action
- Fremanezumab is a human immunoglobulin G2 (IgG2) monoclonal antibody that binds to calcitonin gene-related peptide (CGRP) ligand and blocks its binding to the receptor.
- CGRP is distributed throughout the nervous system, and it is concentrated at anatomical sites, such as the trigeminovascular system, which are involved in migraine pathophysiology.
- Centrally, CGRP is involved in nociceptive transmission through second and third order neurons and pain modulation in the brainstem. Peripherally, CGRP mediates vasodilation through smooth muscle receptors. CGRP concentrations are elevated during acute migraine attacks and may be chronically elevated in chronic migraineurs.6
