Real-world effectiveness of fremanezumab in patients with migraine switching from another mAb targeting the CGRP pathway.

This is a summary of the research article entitled "Real-world effectiveness of fremanezumab in patients with migraine switching from another mAb targeting the CGRP pathway: A subgroup analysis of the Finesse Study".The discovery of calcitonin gene-related peptide (CGRP) as a therapeutic target in migraine has been one of the greatest achievements in neurology in recent years. Specific antibodies against CGRP bind to it either via a receptor (erenumab) or ligand (fremanezumab, galcanezumab, eptinezumab). Monoclonal antibodies (mAbs) are effective, safe and welltolerated drugs that have been approved for prophylactic treatment if there are at least 4 days with migraine per month. However, in clinical practice, the failure of treatment with mAbs has been observed, and thus the question arises whether it is worthwhile to include treatment using an antibody with a different mechanism of action.The Finesse Study was designed to evaluate the efficacy of fremanezumab in patients with a history of prior treatment failure with other mAbs against the CGRP pathway. Among the 153 patients with priorly failed mAbs, switching to fremanezumab led to a ≥50% reduction in the number of days with migraine per month in 42.8% of patients. The conclusion emphasizes that switching to another antibody should be considered in patients with prior therapy failure.