Summary

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• This summary is based on the review of 25 systematic review(s)/meta-analysis(es). ^[1-25]
• Fremanezumab significantly reduced monthly migraine days, with a mean difference of -2.77 days (95% credible intrval (CrI): -3.36 to -2.17) in chronic migraine, and was ranked highest for this outcome with a 0.98 probability.
• The 50% response rate for fremanezumab 225 mg monthly was high, with a risk ratio of 2.98 (95% confidence interval (CI): 2.16, 4.10), and it showed significant reductions in disability, achieving higher proportions of ≥50% reductions in Migraine Disability Assessment (MIDAS) (n = 234) scores compared to placebo.
• Fremanezumab demonstrated effectiveness across both chronic and episodic migraine populations, with 225 mg monthly particularly effective in chronic migraine cases.
• Real-world studies supported fremanezumab’s effectiveness as observed in randomized controlled trials (RCTs), though these studies were limited by retrospective data collection and small patient numbers.
• Fremanezumab had a generally mild safety profile, with adverse events such as general disorders and administration site conditions comparable to placebo, and no significant differences in treatment discontinuation due to adverse events.
• Cardiovascular and cerebrovascular adverse events were infrequent and occurred at similar rates between fremanezumab and placebo groups, with no significant cardiovascular safety concerns identified.
• The number and type of adverse events reported did not significantly differ between the fremanezumab-treated and placebo groups, further supporting its favorable safety profile.
• Fremanezumab was effective across various subgroups, including patients with chronic and episodic migraine, with 85.1% of trial participants being women. It also showed significant efficacy in patients with prior treatment failures, and it was safe and well-tolerated in individuals with cardiovascular risk factors.