Fremanezumab for migraine in clinical practice: a systematic review and meta-analysis.

IF 4.3 2区医学 Q2 CLINICAL NEUROLOGY

Expert Review of Neurotherapeutics Pub Date : 2026-07-01 Epub Date: 2026-06-14 DOI:10.1080/14737175.2026.2687476

Jaime Fernández-Bravo-Rodrigo, Carlos Pascual-Morena, Alicia Saz-Lara, Irene Martínez-García, Carla Geovanna Lever-Megina, Silvana Patiño-Cardona, Amparo Flor-García, Iván Cavero-Redondo

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引用次数: 0

Abstract

Introduction: Although the efficacy of fremanezumab in treating migraine has been proven in randomized controlled trials, its effectiveness is not well understood. Consequently, this study purpose was to synthesize and estimate its real-world effectiveness and safety in patients with migraine.

Methods: A systematic search of PubMed, Scopus and Web of Science was conducted from inception to November2025. Real-world studies evaluating fremanezumab effectiveness, measured by monthly migraine days (MMDs), monthly headache days (MHDs), Headache Impact Test (HIT-6) and related outcomes, including safety, were included. Random-effects meta-analyses were performed.

Results: One month after treatment initiation, fremanezumab reduced MMD by -5.82 days (95% CI: -6.67, -4.97), MHD by -7.30 days (95% CI: -9.72, -4.87) and HIT-6 scores by -6.84 points (95% CI: -10.30, -3.39). Approximately 50% of patients achieved a ≥ 50% reduction in MMD or MHD within 3 months, with response rates increasing progressively up to 12 months. Adverse event rates were 0.05 (95% CI: 0.02, 0.09) in 6 months and 0.07 (95% CI: 0.03, 0.12) in 12 months, with constipation being the most frequently reported event.

Conclusion: Fremanezumab is associated with clinically significant reductions in migraine frequency, disability and acute medication used in real-world settings, with a favorable safety profile.

Prospero: CRD42021266322.

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Fremanezumab治疗偏头痛的临床实践：系统回顾和荟萃分析。

导读：尽管fremanezumab治疗偏头痛的疗效已在随机对照试验中得到证实，但其有效性尚不清楚。因此，本研究的目的是综合和评估其在偏头痛患者中的实际有效性和安全性。方法：系统检索PubMed、Scopus和Web of Science，检索时间为建刊至2025年11月。评估fremanezumab有效性的真实世界研究，包括每月偏头痛天数（MMDs）、每月头痛天数（MHDs）、头痛影响测试（HIT-6）和相关结果，包括安全性。进行随机效应荟萃分析。结果：治疗开始一个月后，fremanezumab使MMD减少-5.82天（95% CI: -6.67, -4.97）， MHD减少-7.30天（95% CI: -9.72, -4.87）， HIT-6评分减少-6.84分（95% CI: -10.30, -3.39）。大约50%的患者在3个月内实现MMD或MHD减少≥50%，缓解率逐渐增加到12个月。6个月不良事件发生率为0.05 (95% CI: 0.02, 0.09)， 12个月不良事件发生率为0.07 (95% CI: 0.03, 0.12)，便秘是最常见的不良事件。结论：Fremanezumab与临床上显著降低偏头痛频率、致残和在现实环境中使用的急性药物相关，具有良好的安全性。普洛斯彼罗:CRD42021266322。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Expert Review of Neurotherapeutics Medicine-Neurology (clinical)

CiteScore

7.00

自引率

2.30%

发文量

审稿时长

4-8 weeks

期刊介绍： Expert Review of Neurotherapeutics (ISSN 1473-7175) provides expert reviews on the use of drugs and medicines in clinical neurology and neuropsychiatry. Coverage includes disease management, new medicines and drugs in neurology, therapeutic indications, diagnostics, medical treatment guidelines and neurological diseases such as stroke, epilepsy, Alzheimer''s and Parkinson''s. Comprehensive coverage in each review is complemented by the unique Expert Review format and includes the following sections: Expert Opinion - a personal view of the data presented in the article, a discussion on the developments that are likely to be important in the future, and the avenues of research likely to become exciting as further studies yield more detailed results Article Highlights – an executive summary of the author’s most critical points