From the Guidelines
Ajovy (fremanezumab) is a recommended medication for the prevention of episodic or chronic migraine, administered as a monthly 225 mg subcutaneous injection or as a quarterly 675 mg dose. According to the 2023 U.S. Department of Veterans Affairs and U.S. Department of Defense clinical practice guideline for the management of headache 1, fremanezumab is one of the recommended medications for the prevention of episodic or chronic migraine, along with erenumab and galcanezumab. The guideline states that these medications are recommended with strong evidence, indicating their effectiveness in reducing migraine frequency.
The dosage and administration of Ajovy are crucial for its effectiveness. It can be self-administered using prefilled syringes or autoinjectors after proper training. The medication should be stored in the refrigerator but can be kept at room temperature for up to 24 hours before use. Common side effects of Ajovy include injection site reactions such as redness, pain, or itching.
It's essential to note that Ajovy is a preventive medication, not intended for acute migraine treatment. Continuing the regular dosing schedule is crucial for optimal effectiveness. The medication has shown effectiveness in reducing both episodic and chronic migraine frequency, with many patients experiencing fewer headache days per month.
In comparison to other medications, the 2021 study on diagnosis and management of migraine in ten steps 1 provides a comprehensive table of preventive migraine treatments, including Ajovy (fremanezumab). However, the most recent and highest-quality study, the 2023 U.S. Department of Veterans Affairs and U.S. Department of Defense clinical practice guideline for the management of headache 1, takes precedence in guiding the recommendation for Ajovy.
Key points to consider when prescribing Ajovy include:
- Administration: monthly 225 mg subcutaneous injection or quarterly 675 mg dose
- Storage: refrigerator, but can be kept at room temperature for up to 24 hours before use
- Common side effects: injection site reactions
- Indication: prevention of episodic or chronic migraine
- Importance of continued regular dosing for optimal effectiveness
Overall, Ajovy (fremanezumab) is a recommended medication for the prevention of episodic or chronic migraine, with a strong evidence base supporting its effectiveness 1.
From the FDA Drug Label
AJOVY (fremanezumab-vfrm) injection is a sterile, preservative-free, clear to opalescent, colorless to slightly yellow solution for subcutaneous administration. AJOVY is supplied as follows: Prefilled Autoinjector Pack of 1 autoinjector: 225 mg/1. 5 mL single-dose prefilled autoinjector AJOVY is a prescription medicine used for the preventive treatment of migraine in adults.
Main Use of Ajovy:
- AJOVY is used for the preventive treatment of migraine in adults.
- The dosage is either 225 mg one time every month or 675 mg one time every 3 months, administered subcutaneously.
- If the prescribed dose is 675 mg every 3 months, it must be administered as three consecutive subcutaneous injections of 225 mg each 2.
From the Research
Ajovy (Fremanezumab) Overview
- Ajovy (fremanezumab) is a fully humanized monoclonal antibody that selectively binds both isoforms of the calcitonin gene-related peptide (CGRP) 3, 4.
- It is indicated for prophylaxis of migraine in adults who have at least four migraine days per month 3.
- Ajovy can be administered as a subcutaneous injection using an autoinjector device, with two dosing options: 225 mg once a month or 675 mg quarterly 3.
Efficacy and Safety
- Fremanezumab has demonstrated efficacy and had a favorable tolerability profile in Phase III clinical trials for episodic and chronic migraine, with no serious treatment-related adverse events 3.
- The approval of fremanezumab and other CGRP monoclonal antibodies has introduced a new era in the treatment of migraine, with a favorable efficacy and safety profile maintained over the long term 4.
- Studies have shown that CGRP monoclonal antibodies, including fremanezumab, are effective in reducing medication overuse headache in chronic migraine patients 5.
- A comparison study between erenumab, fremanezumab, and galcanezumab found that these treatments have excellent efficacy and tolerability in the preventive treatment of high frequency episodic migraine and chronic migraine 6.
Real-World Effectiveness
- Real-world studies have shown that erenumab and galcanezumab, similar to fremanezumab, are effective in reducing monthly headache days and migraine-specific medication days in patients with difficult-to-treat migraine 7.
- These studies suggest that CGRP monoclonal antibodies, including fremanezumab, can reduce not only the frequency but also the intensity of migraines 7.