Analysis of retreatment with monoclonal antibodies in chronic/episodic migraine: Real world data

Abstract

Objective

To analyze the response to retreatment in patients with chronic/episodic migraine who discontinued therapy with erenumab/fremanezumab after 1 year of treatment.

Methods

Observational, retrospective, single-center, multidisciplinary study in patients with chronic/episodic migraine who received therapy with erenumab/fremanezumab for at least 1 year and discontinued it after achieving an adequate response (optimization). The evaluation of the response after retreatment included the following variables: DMM, MIDAS, and HIT-6 scales at the beginning of retreatment and 3 months later. The response was evaluated in different subgroups (episodic/chronic, erenumab/fremanezumab, and time until retreatment).

Results

48 patients were included. 70.8% (n = 34) required retreatment with mAb, with a median of 3.9 (2.9–6.4) months until reintroduction. Clinical response after retreatment was achieved in 67.6% (n = 23) of patients. No statistically significant differences were found in the analyzed subgroups.

Conclusion

Interruption of treatment with erenumab/fremanezumab for chronic/episodic migraine produces a clinical worsening of the disease requiring retreatment in most cases, approximately after 4 months. Two out of three patients respond positively after restarting monoclonal therapy. This response does not appear to be related to the type of migraine, the specific monoclonal antibody prescribed, or the time to retreatment.