OBJECTIVES: This study examined the demographic and clinical characteristics of all patients in Sweden treated with fremanezumab, a monoclonal antibody (mAb) targeting the calcitonin gene‑related peptide (CGRP) pathway, for migraine prevention.

METHODS: This retrospective, non-interventional, observational study utilized data from Swedish national population registers between 1 June 2005 and 28 February 2022. The study included all patients ≥18 years of age with ≥1 prescription of fremanezumab (first dispensation designated as index date). Outcomes included adherence (medication possession rate [MPR], proportion of days covered [PDC]) and persistence (patients staying on treatment throughout the follow-up period) to fremanezumab treatment. Herein we report data on patients with a pre-index period of ≥12 months and ≥6 months of follow-up post-index.

RESULTS: Of the 2865 eligible patients identified, 2211 had a post-index period of ≥6 months (mean [SD] age of 46.4 [12.1] years; 84.1% women). 1114 patients were previously treated with another CGRP pathway mAb (erenumab [n = 1108 {50.1%}] or galcanezumab [n = 6 {0.27%}]) in the 12 months prior to initiating fremanezumab. The patient group with previous exposure to another CGRP pathway mAb had a higher mean age, a larger proportion of migraine diagnoses registered in specialty care, higher mean migraine-related healthcare resource utilization, and a higher mean number of migraine-related sick leave days compared with the patient group naïve to CGRP pathway mAbs. At 6 months post-index, the mean (SD) MPR and the mean (SD) PDC was 85.3 (23.9) and 84.3 (23.8), respectively, with 73.6% of patients persistent with fremanezumab.

CONCLUSIONS: In this real-world study, patients with migraine demonstrated high levels of adherence and persistence to fremanezumab. More than half of the study population had previously used erenumab before initiating fremanezumab. Patients with previous exposure to another CGRP pathway mAb appeared to be more severely impacted by migraine than those naïve to CGRP pathway mAbs.