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Study breakdown

Who Responds Best to Fremanezumab? Real-World Predictors from a Hospital Study

ObservationalLow Moderate evidence
The takeaway

In 89 migraine patients, fremanezumab reduced headache days significantly, with treatment-naive patients and certain clinical profiles predicting better response.

89 patients

Prospective real-world cohort with response predictor analysis for fremanezumab

What the researchers found

Fremanezumab significantly reduced headache days in 89 patients, with treatment-naive status among the factors predicting better response.

Why it matters

With multiple CGRP antibodies available, knowing which patients respond best to fremanezumab helps personalize migraine prevention.

The numbers in context

N=89; headache days dropped from 21.1 to 12.4 per quarter; 61.8% achieved >=50% response; 6/10 erenumab non-responders responded to fremanezumab.

How the study worked

Prospective observational study tracking headache days one quarter before and after fremanezumab initiation in 89 patients.

Who was studied

Adults with high-frequency episodic or chronic migraine at a Spanish hospital (86.5% female, mean age 45.8)

What this study cannot tell us

Single-center observational study with relatively short follow-up (one quarter). No control group.

How to read the evidence

Prospective observational study — better than retrospective but lacks randomization and control group.

When this study was published

Published in 2025, reflecting current real-world prescribing patterns for the third available CGRP antibody.

The bigger picture

Real-world response predictor data helps move migraine treatment from trial-and-error toward personalized medicine.

Questions still open

  • Do response predictors differ between fremanezumab and other CGRP antibodies?
  • Do benefits increase or plateau with longer treatment duration?

Common questions

How effective is fremanezumab in the real world?
This study of 89 patients showed significant headache day reduction, with treatment-naive patients among those responding best.
Who is most likely to respond to fremanezumab?
Patients who haven't tried other CGRP antibodies and certain clinical profiles predicted better response in this study.

Read the original research

Real-World Lessons with Fremanezumab as the Third Available CGRP Monoclonal Antibody in a Third-Level Hospital: Focus on the Factors Predicting Response.

Journal of clinical medicine, 14(4)

Citation

Polanco, Marcos; Gárate, Gabriel; Sánchez-Gudín, Julia; Madera, Jorge; Pascual, Julio; González-Quintanilla, Vicente. (2025). Real-World Lessons with Fremanezumab as the Third Available CGRP Monoclonal Antibody in a Third-Level Hospital: Focus on the Factors Predicting Response.. Journal of clinical medicine, 14(4). https://doi.org/10.3390/jcm14041054