Tolerability of switch from erenumab to fremanezumab in adults with chronic migraine: a 3-month, single-center, prospective, real-world, observational study

Abstract Objective While erenumab and fremanezumab are effective treatments for migraine prevention, it is unclear whether patients who experience adverse events related to erenumab can tolerate fremanezumab. This study evaluated the tolerability of switching from erenumab to fremanezumab in patient...

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Main Authors: Faisal Mohammad Amin, Thor Linnet, Christopher Kjaer Cullum, Thien Phu Do, Samaira Younis
Format: Article
Language:English
Published: BMC 2025-07-01
Series:The Journal of Headache and Pain
Subjects:
Online Access:https://doi.org/10.1186/s10194-025-02087-z
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author Faisal Mohammad Amin
Thor Linnet
Christopher Kjaer Cullum
Thien Phu Do
Samaira Younis
author_facet Faisal Mohammad Amin
Thor Linnet
Christopher Kjaer Cullum
Thien Phu Do
Samaira Younis
author_sort Faisal Mohammad Amin
collection DOAJ
description Abstract Objective While erenumab and fremanezumab are effective treatments for migraine prevention, it is unclear whether patients who experience adverse events related to erenumab can tolerate fremanezumab. This study evaluated the tolerability of switching from erenumab to fremanezumab in patients with chronic migraine who experienced adverse events on erenumab. Methods Data was obtained from adult patients with chronic migraine who failed erenumab treatment due to lack of tolerability and subsequently received at least three months of treatment with fremanezumab after discontinuing erenumab. Adverse events were recorded before and after the switch. Results In total, 94 patients were enrolled, with a median age of 50 years. Hereof, 29 (31%) participants experienced treatment-emergent adverse events during the study period after switching from erenumab to fremanezumab. The most prevalent adverse event on erenumab before switching was constipation (n = 74, 79%), which reduced to only 12% (n = 9) of patients who switched to fremanezumab. There was no treatment discontinuation after switching to fremanezumab during the three-months study period. Conclusion Switching treatment from erenumab to fremanezumab due to adverse events is well-tolerated in patients with chronic migraine. This findings suggests a viable option to switch between treatments. Further studies are needed to assess the efficacy of switching between these treatments.
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issn 1129-2377
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spelling doaj-art-a29e9118bc0f44caac2ec8beb9ec63222025-08-20T03:45:36ZengBMCThe Journal of Headache and Pain1129-23772025-07-012611710.1186/s10194-025-02087-zTolerability of switch from erenumab to fremanezumab in adults with chronic migraine: a 3-month, single-center, prospective, real-world, observational studyFaisal Mohammad Amin0Thor Linnet1Christopher Kjaer Cullum2Thien Phu Do3Samaira Younis4Department of Neurology, Danish Headache Center, Copenhagen University Hospital– RigshospitaletDepartment of Neurology, Danish Headache Center, Copenhagen University Hospital– RigshospitaletDepartment of Neurology, Danish Headache Center, Copenhagen University Hospital– RigshospitaletDepartment of Neurology, Danish Headache Center, Copenhagen University Hospital– RigshospitaletDepartment of Neurology, Danish Headache Center, Copenhagen University Hospital– RigshospitaletAbstract Objective While erenumab and fremanezumab are effective treatments for migraine prevention, it is unclear whether patients who experience adverse events related to erenumab can tolerate fremanezumab. This study evaluated the tolerability of switching from erenumab to fremanezumab in patients with chronic migraine who experienced adverse events on erenumab. Methods Data was obtained from adult patients with chronic migraine who failed erenumab treatment due to lack of tolerability and subsequently received at least three months of treatment with fremanezumab after discontinuing erenumab. Adverse events were recorded before and after the switch. Results In total, 94 patients were enrolled, with a median age of 50 years. Hereof, 29 (31%) participants experienced treatment-emergent adverse events during the study period after switching from erenumab to fremanezumab. The most prevalent adverse event on erenumab before switching was constipation (n = 74, 79%), which reduced to only 12% (n = 9) of patients who switched to fremanezumab. There was no treatment discontinuation after switching to fremanezumab during the three-months study period. Conclusion Switching treatment from erenumab to fremanezumab due to adverse events is well-tolerated in patients with chronic migraine. This findings suggests a viable option to switch between treatments. Further studies are needed to assess the efficacy of switching between these treatments.https://doi.org/10.1186/s10194-025-02087-zCalcitonin gene-related peptideCGRPHeadacheConstipationGastrointestinal symptomsMigraine with aura
spellingShingle Faisal Mohammad Amin
Thor Linnet
Christopher Kjaer Cullum
Thien Phu Do
Samaira Younis
Tolerability of switch from erenumab to fremanezumab in adults with chronic migraine: a 3-month, single-center, prospective, real-world, observational study
The Journal of Headache and Pain
Calcitonin gene-related peptide
CGRP
Headache
Constipation
Gastrointestinal symptoms
Migraine with aura
title Tolerability of switch from erenumab to fremanezumab in adults with chronic migraine: a 3-month, single-center, prospective, real-world, observational study
title_full Tolerability of switch from erenumab to fremanezumab in adults with chronic migraine: a 3-month, single-center, prospective, real-world, observational study
title_fullStr Tolerability of switch from erenumab to fremanezumab in adults with chronic migraine: a 3-month, single-center, prospective, real-world, observational study
title_full_unstemmed Tolerability of switch from erenumab to fremanezumab in adults with chronic migraine: a 3-month, single-center, prospective, real-world, observational study
title_short Tolerability of switch from erenumab to fremanezumab in adults with chronic migraine: a 3-month, single-center, prospective, real-world, observational study
title_sort tolerability of switch from erenumab to fremanezumab in adults with chronic migraine a 3 month single center prospective real world observational study
topic Calcitonin gene-related peptide
CGRP
Headache
Constipation
Gastrointestinal symptoms
Migraine with aura
url https://doi.org/10.1186/s10194-025-02087-z
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