Fremanezumab May Be Efficacious for Comorbid Chronic Migraine and Depression

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Chronic migraine was defined as at least 15 monthly headache days and at least 8 monthly migraine days.
Chronic migraine was defined as at least 15 monthly headache days and at least 8 monthly migraine days.

The following article is part of conference coverage from the PAINWeek 2018 conference in Las Vegas, Nevada. Clinical Pain Advisor's staff will be reporting breaking news associated with research conducted by leading experts in pain medicine. Check back for the latest news from PAINWeek 2018.

LAS VEGAS — Fremanezumab may be efficacious for the prophylaxis of chronic migraine in individuals with comorbid migraine and moderate/moderate to severe depression. The treatment may also improve symptoms of depression, according to a study presented during the 2018 PAINWeek conference, held September 4-8. This multicenter phase 3 double-blind randomized study included 1130 participants between the ages of 18 and 70 who had been diagnosed with chronic migraine. Researchers randomly assigned patients at a 1:1:1 ratio to receive quarterly fremanezumab (baseline dosage, 675 mg; weeks 4 and 8, placebo), monthly fremanezumab (baseline dosage, 675 mg; weeks 4 and 8, fremanezumab 225 mg), or placebo over a 12-week period.

Chronic migraine was defined as at least 15 monthly headache days and at least 8 monthly migraine days. Moderate to moderately severe depression was defined as a baseline score between 10 and 19 on the 9-item Patient Health Questionnaire.

Of all the participants, 219 had comorbid depression that ranged from moderate to moderately severe (n=74 in the quarterly group; n=88 in the monthly group; n=57 in the placebo group). Treatment with fremanezumab was found to reduce the number of mean monthly headache days in participants with comorbid chronic migraine and depression (quarterly fremanezumab, -5.4±0.79; monthly fremanezumab, -5.6±0.75) when compared with placebo (-2.2±0.84; P <.001 for both). 

The mean number of migraine days also showed improvement (P <.001), as did the mean 9-item Patient Health Questionnaire score, which was reduced at the 12-week time point from baseline (quarterly fremanezumab, –10.5±0.68, P <.05; monthly fremanezumab, –9.5±0.63; placebo, -8.7±0.71,).  “[Fremanezumab] demonstrated efficacy in preventive treatment of [chronic migraine] in patients with comorbid moderate to moderately severe depression, reducing migraine and headache frequency and improving depression,” concluded the study authors.

Multiple authors declare affiliations with the pharmaceutical industry. Please refer to reference for a complete list of authors' disclosures.

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Reference

Cohen J, Yeung P, Yang R, et al. Efficacy of fremanezumab in patients with chronic migraine and comorbid moderate to moderately severe depression. Poster presentation at: Painweek; September 4-8, 2018; Las Vegas, NV. Abstract 58.

For more coverage of PAINWeek 2018, click here.

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