fremanezumab

Fremanezumab is a human monoclonal antibody used for the preventive treatment of migraine in adults. It binds to the calcitonin gene-related peptide (CGRP) ligand, blocking its interaction with the CGRP receptor and thereby reducing migraine risk.

Pharmacology and use: By targeting CGRP, fremanezumab interferes with a pathway involved in migraine development and transmission. It is given by subcutaneous injection and is designed for monthly dosing, with flexible regimens to suit patient preference and response.

Dosing and administration: For episodic migraine, dosing options include 675 mg once a month or 225 mg once a month for three consecutive months. The same regimens apply for chronic migraine. Injections can be administered by patients or caregivers after appropriate training and may be given in the thigh or abdomen.

Efficacy: In phase 3 trials, fremanezumab reduced the number of monthly migraine days compared with placebo in both episodic and chronic migraine populations. Benefits were observed early and persisted over the treatment period.

Safety and tolerability: The most common adverse events are injection-site reactions (pain, redness, swelling) and upper respiratory tract infections. Hypersensitivity reactions are rare. As with other monoclonal antibodies, immunogenicity and long-term safety are considerations, and use during pregnancy should be discussed with a clinician.

Regulatory status: Fremanezumab was approved by the U.S. Food and Drug Administration for migraine prevention in adults in 2018 and has since obtained approval in other regions for the same indication.