Key clinical point: Patients with chronic migraine may be informed that they should not expect a consistent wearing-off effect when being treated with erenumab or fremanezumab as anxiety regarding attacks toward the end of the month may potentially trigger further migraine episodes.
Major finding: Overall, 62% of patients treated with erenumab and fremanezumab achieved a consistent ≥30% reduction in migraine days over 2 consecutive months (≥30% responders), with no consistent wearing-off effect (ie, an increase of ≥2 weekly migraine days from week 2 to 4 over 2 consecutive treatment months) in the erenumab ( P = .194) and fremanezumab ( P = .581) groups. Among ≥30% responders, there was no significant wearing-off effect from week 2 to 4 over 2 consecutive months (1.43 vs 1.52 days; P = .573).
Study details: This single-center, real-world, observational study included 100 patients with chronic migraine (age ≥ 18 years) who received either erenumab (n = 60) or fremanezumab (n = 40).
Disclosures: This study was supported by Lundbeck Foundation. Two authors declared receiving personal fees or honoraria from or serving on advisory boards for various sources.
Source: Florescu AM, Lannov LV, Younis S et al. No wearing-off effect of erenumab or fremanezumab for chronic migraine prevention: A single-center, real-world, observational study. Cephalalgia. 2024 (Jan 12). doi: 10.1177/03331024231222 Source.