Evidence map›Paper›PMID 38451463›Full record

ArticleNeurology and therapy2024

Assessing the Long-Term (48-Week) Effectiveness, Safety, and Tolerability of Fremanezumab in Migraine in Real Life: Insights from the Multicenter, Prospective, FRIEND3 Study.

Piero Barbanti, Gabriella Egeo, Stefania Proietti, Florindo d'Onofrio, Cinzia Aurilia, Cinzia Finocchi, Laura Di Clemente, Maurizio Zucco, Alberto Doretti, Stefano Messina and 23 more

Erratum issuedOpen access · goldAbstract read
In one paragraph

Article in Neurology and therapy, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 11 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed, 1 pooled it
6.2field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

11 citing papers in PubMed, 1 synthesis or guideline pooled it, 16 citations in OpenAlex.

  1. Pooled it
  2. The second interim analysis of Italian participants enrolled in the real-world, Pan-European, prospective, observational, Phase 4 PEARL study of fremanezumab effectiveness.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2025
    Trial
  3. Long-term real-world effectiveness and safety of fremanezumab in 1140 patients with migraine and at least 6 months of treatment: third interim analysis of the pan-European PEARL study.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2025
    Trial
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

33 authors at 20 institutions in 1 country.

Piero Barbanti *Headache and Pain Unit, IRCCS San Raffaele, Via Della Pisana 235, 00163, Rome, Italy. piero.barbanti@sanraffaele.it.ORCID http://orcid.org/0000-0002-5670-3755
Gabriella Egeo *Headache and Pain Unit, IRCCS San Raffaele, Via Della Pisana 235, 00163, Rome, Italy.
Stefania ProiettiClinical and Molecular Epidemiology, IRCCS San Raffaele, Rome, Italy.
Florindo d'OnofrioNeurology Unit, San Giuseppe Moscati Hospital, Avellino, Italy.
Cinzia AuriliaHeadache and Pain Unit, IRCCS San Raffaele, Via Della Pisana 235, 00163, Rome, Italy.
Cinzia FinocchiNeurology Unit, San Paolo Hospital, ASL 2, Savona, Italy.
Laura Di ClementeHeadache Center, Neurology Unit, San Camillo-Forlanini Hospital, Rome, Italy.
Maurizio ZuccoHeadache Center, Neurology Unit, San Camillo-Forlanini Hospital, Rome, Italy.
Alberto DorettiLaboratory of Neuroscience, Department of Neurology-Stroke Unit, Istituto Auxologico Italiano, IRCCS, Milano, Italy.
Stefano MessinaLaboratory of Neuroscience, Department of Neurology-Stroke Unit, Istituto Auxologico Italiano, IRCCS, Milano, Italy.
Massimo AutunnoDepartment of Clinical and Experimental Medicine, University of Messina, Messina, Italy.
Angelo RanieriNeurology Unit and Stroke-Unit, AORN A. Cardarelli, Naples, Italy.
Antonio CarnevaleHeadache Center, Neurology Unit, San Filippo Neri Hospital, Rome, Italy.
Bruno ColomboDepartment of Neurology, Headache Unit, Scientific Institute San Raffaele Hospital, Vita-Salute University, Milan, Italy.
Massimo FilippiDepartment of Neurology, Headache Unit, Scientific Institute San Raffaele Hospital, Vita-Salute University, Milan, Italy.
Miriam TasilloStroke Unit, S. Camillo de Lellis Hospital, Rieti, Italy.
Steno RinalduzziStroke Unit, S. Camillo de Lellis Hospital, Rieti, Italy.
Pietro QuerzaniNeurology Unit, S. Maria Delle Croci Hospital-AUSL Romagna, Ravenna, Italy.
Giuliano SetteDepartment of Neuroscience, Mental Health and Sensory Organs (NESMOS), Sant'Andrea University Hospital, "Sapienza" University of Rome, Rome, Italy.
Lorenzo ForinoNeurology Unit, San Giuseppe Moscati Hospital, Avellino, Italy.
Francesco ZorodduNeurology Unit, Pediatric Headache Center, University of Sassari, Sassari, Italy.
Micaela RobottiHeadache Center, ASST Santi Paolo Carlo, Milan, Italy.
Alessandro ValenzaHeadache Center, UOC Neurology, Ospedale Belcolle, Viterbo, Italy.
Cecilia CamardaDepartment of Biomedicine, Neurosciences, and Advanced Diagnostics, University of Palermo, Palermo, Italy.
Laura BorrelloFrosinone Hospital, Headache Center, Frosinone, Italy.
Marco AguggiaNeurology and Stroke Unit, Cardinal Massaia Hospital, Asti, Italy.
Giovanna ViticchiNeurological Clinic, Marche Polytechnic University, Ancona, Italy.
Carlo TominoScientific Direction IRCCS San Raffaele, Rome, Italy.
Giulia FiorentiniSan Raffaele University, Rome, Italy.
Bianca OrlandoHeadache and Pain Unit, IRCCS San Raffaele, Via Della Pisana 235, 00163, Rome, Italy.
Stefano BonassiClinical and Molecular Epidemiology, IRCCS San Raffaele, Roma, Italy.
Paola TorelliDepartment of Medicine and Surgery, Headache Center, Neurology Unit, University of Parma, Parma, Italy.
Italian Migraine Registry study group
Vita-Salute San Raffaele University · ITIRCCS Ospedale San Raffaele · ITAzienda Ospedaliera S.Giuseppe Moscati · ITCarlo Forlanini Hospital · ITIRCCS Istituto Auxologico Italiano · ITSan Raffaele University of Rome · ITAccademia di Belle Arti di Frosinone · ITAzienda Ospedaliera Sant'Andrea · ITAzienda Sanitaria Locale di Asti · ITMarche Polytechnic University · ITOspedale Antonio Cardarelli · ITOspedale di Belcolle · ITOspedale San Carlo · ITOspedale San Filippo Neri · ITOspedale San Paolo · ITOspedale "Santa Maria delle Croci" di Ravenna · ITUniversity of Messina · ITUniversity of Palermo · ITUniversity of Parma · ITUniversity of Sassari · IT

Funding

Institutional Funding Ricerca Corrente IRCCS San Raffaele
6 · The paper itself

Abstract

introductionLong-term (1-year) fremanezumab treatment proved to be effective, safe, and well tolerated in individuals with migraine and < 2 medication clusters in a randomized controlled trial (RCT). We aimed to assess real-world evidence (RWE), long-term effectiveness, tolerability, and safety of fremanezumab in people with high-frequency episodic migraine (HFEM) or chronic migraine (CM) with > 3 treatment failures and various comorbidities.

methodsA 48-week, prospective, multicenter (n = 26), cohort study assessed fremanezumab's effectiveness, safety, and tolerability in consecutive adults with HFEM or CM with > 3 treatment failures. Primary endpoint was variation from baseline in monthly migraine days (MMD) in HFEM and monthly headache days (MHD) in CM at weeks 45-48. Secondary endpoints were changes in monthly analgesic medications, Numerical Rating Scale (NRS), Headache Impact Test (HIT-6), and the Migraine Disability Assessment Scale (MIDAS) scores and ≥ 50%, ≥ 75%, and 100% responder rates.

resultsOf 533 participants who had received ≥ 1 fremanezumab dose, 130 were treated for ≥ 48 weeks and considered for effectiveness analysis. No participant missed any treatment dosage every other consecutive month during the 12-month period. PRIMARY ENDPOINT: fremanezumab significantly (p < 0.001) reduced both MMD (- 6.4) in HFEM and MHD (- 14.5) in CM. Secondary endpoints: a significant reduction (p < 0.001) was observed in monthly analgesic medications (HFEM - 6.0; CM -16.5), NRS (HFEM - 3.4; CM - 3.4), HIT-6 (HFEM - 16.9; CM - 17.9) and MIDAS score (HFEM - 50.4; CM - 76.6). The ≥ 50%, ≥ 75%, and 100% response rates to fremanezumab were 75.5%, 36.7%, and 2% in HFEM and 71.6%, 44.4%, and 3.7% in CM. Corresponding response rates were 60.5%, 37.2%, and 2.3% in individuals with psychiatric comorbidities, 74.2%, 50%, and 4.8% in CM with medication overuse, and 60.9%, 39.1%, and 4.3% in CM with medication overuse and psychiatric comorbidities. Mild and transient treatment-emergent adverse events occurred in 7.8% of the participants. No subject discontinued the treatment for any reason.

conclusionThis RWE study documents that long-term fremanezumab treatment is highly effective and remarkably well tolerated in subjects with HFEM or CM with multiple (> 3) therapeutic failures, even in the presence of concomitant medication overuse, psychiatric comorbidities, or both. The effectiveness-to-tolerability ratio appears to be better in RWE than in RCTs.

Indexed as

CGRP monoclonal antibodyDisabilityFremanezumabLong-term treatmentMedication overuseMigraine treatmentPsychiatric comorbiditiesReal-world

Identifiers

PMID38451463
PMCPMC11136914
OpenAlexW4392563985

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.