Predictors of Response to Fremanezumab in Migraine Patients with at Least Three Previous Preventive Failures: Post Hoc Analysis of a Prospective, Multicenter, Real-World Greek Registry

Argyriou, Andreas A.; Dermitzakis, Emmanouil V.; Xiromerisiou, Georgia; Rallis, Dimitrios; Soldatos, Panagiotis; Litsardopoulos, Pantelis; Vikelis, Michail

doi:10.3390/jcm12093218

Open AccessArticle

Predictors of Response to Fremanezumab in Migraine Patients with at Least Three Previous Preventive Failures: Post Hoc Analysis of a Prospective, Multicenter, Real-World Greek Registry

by

Andreas A. Argyriou

^1,*

,

Emmanouil V. Dermitzakis

²

,

Georgia Xiromerisiou

³

,

Dimitrios Rallis

⁴,

Panagiotis Soldatos

⁵,

Pantelis Litsardopoulos

¹ and

Michail Vikelis

⁶

¹

Headache Outpatient Clinic, Neurology Department, Agios Andreas State General Hospital of Patras, 26335 Patras, Greece

²

Euromedica General Clinic, 54645 Thessaloniki, Greece

³

Department of Neurology, School of Medicine, University of Thessaly, 41221 Larissa, Greece

⁴

Department of Neurology, Tzaneio General Hospital of Piraeus, 18536 Athens, Greece

⁵

Private Practice, 24100 Kalamata, Greece

⁶

Headache Clinic, Mediterraneo Hospital, 16673 Glyfada, Greece

^*

Author to whom correspondence should be addressed.

J. Clin. Med. 2023, 12(9), 3218; https://doi.org/10.3390/jcm12093218

Submission received: 13 April 2023 / Revised: 24 April 2023 / Accepted: 28 April 2023 / Published: 29 April 2023

(This article belongs to the Special Issue Headache Disorders: New Advances in Management and Treatment Strategies)

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Abstract

Objective: To define, in a real-world population of patients with high-frequency episodic (HFEM) or chronic migraine (CM), the predictive role of socio-demographic or phenotypic profiling of responders to fremanezumab. Patients and methods: Two-hundred and four adult fremanezumab-treated patients with either HFEM or CM, who failed to at least three preventive treatments, provided data at baseline on several individual socio-demographic and phenotypic variables. These variables were analyzed for their ability to independently predict the response (50–74% response rates) or super-response (≥ 75% response rates) to fremanezumab. Patients were followed from 3–18 months of fremanezumab exposure. Results: The main finding to emerge from univariate analyses was that three baseline socio-demographic/clinical variables, i.e., age group 41–70 years (p = 0.02); female gender (p = 0.03); patients with HFEM (p = 0.001), and three clinical phenotypic variables, i.e., strict unilateral pain (p = 0.05); pain in the ophthalmic trigeminal branch (p = 0.04); and the “imploding” quality of pain (p = 0.05), were significantly related to fremanezumab response. However, in multivariate analysis, only HFEM (p = 0.02), the presence of strict unilateral (p = 0.03), and pain location in the ophthalmic trigeminal branch (p = 0.036) were independently associated with good fremanezumab response. Allodynia (p = 0.04) was the only clinical predictive variable of super-responsiveness to fremanezumab. Conclusions: A precise phenotypic profiling with identification of pain characteristics consistent with peripheral and/or central sensitization might reliably predict the responsiveness to fremanezumab in migraine prophylaxis.

Keywords: CGRP; monoclonal antibodies; fremanezumab; phenotypes; predictors; response; episodic migraine; chronic migraine

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MDPI and ACS Style

Argyriou, A.A.; Dermitzakis, E.V.; Xiromerisiou, G.; Rallis, D.; Soldatos, P.; Litsardopoulos, P.; Vikelis, M. Predictors of Response to Fremanezumab in Migraine Patients with at Least Three Previous Preventive Failures: Post Hoc Analysis of a Prospective, Multicenter, Real-World Greek Registry. J. Clin. Med. 2023, 12, 3218. https://doi.org/10.3390/jcm12093218

AMA Style

Argyriou AA, Dermitzakis EV, Xiromerisiou G, Rallis D, Soldatos P, Litsardopoulos P, Vikelis M. Predictors of Response to Fremanezumab in Migraine Patients with at Least Three Previous Preventive Failures: Post Hoc Analysis of a Prospective, Multicenter, Real-World Greek Registry. Journal of Clinical Medicine. 2023; 12(9):3218. https://doi.org/10.3390/jcm12093218

Chicago/Turabian Style

Argyriou, Andreas A., Emmanouil V. Dermitzakis, Georgia Xiromerisiou, Dimitrios Rallis, Panagiotis Soldatos, Pantelis Litsardopoulos, and Michail Vikelis. 2023. "Predictors of Response to Fremanezumab in Migraine Patients with at Least Three Previous Preventive Failures: Post Hoc Analysis of a Prospective, Multicenter, Real-World Greek Registry" Journal of Clinical Medicine 12, no. 9: 3218. https://doi.org/10.3390/jcm12093218

APA Style

Argyriou, A. A., Dermitzakis, E. V., Xiromerisiou, G., Rallis, D., Soldatos, P., Litsardopoulos, P., & Vikelis, M. (2023). Predictors of Response to Fremanezumab in Migraine Patients with at Least Three Previous Preventive Failures: Post Hoc Analysis of a Prospective, Multicenter, Real-World Greek Registry. Journal of Clinical Medicine, 12(9), 3218. https://doi.org/10.3390/jcm12093218

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Predictors of Response to Fremanezumab in Migraine Patients with at Least Three Previous Preventive Failures: Post Hoc Analysis of a Prospective, Multicenter, Real-World Greek Registry

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