|Target||Calcitonin gene-related peptide (CGRP) α, β|
|Other names||TEV-48125, fremanezumab-vfrm|
|Drug class||Calcitonin gene-related peptide antagonist|
|Main uses||Prevent migraines|
|Side effects||Pain at site of injection, allergic reactions|
|Typical dose||225 mg q month|
|Elimination half-life||30–31 days (estimated)|
|Chemical and physical data|
|Molar mass||145507.54 g·mol−1|
Common side effect include pain and redness at the site of injection. Other side effects may include allergic reactions. Safety in pregnancy and breastfeeding is unclear. It is in the calcitonin gene-related peptide (CGRP) antagonist class of medications.
Fremanezumab was approved for medical use in the United States in 2018, Europe in 2019, and the UK in 2020. In the United States it costs 625 USD per month as of 2021. In the United Kingdom this amount costs the NHS about £450.
Fremanezumab was shown to be effective in adults with four or more attacks per month.
It is given at a dose of 225 mg once per month or 675 mg once every 3 months.
The most common side effects are reactions at the injection site, which occurred in 43 to 45% of people in studies (as compared to 38% under placebo). Hypersensitivity reactions occurred in fewer than 1% of patients.
Fremanezumab does not interact with other antimigraine drugs such as triptans, ergot alkaloids and analgesics. It is expected to generally have a low potential for interactions because it is not metabolized by cytochrome P450 enzymes.
Mechanism of action
Fremanezumab is a fully humanized monoclonal antibody directed against calcitonin gene-related peptides (CGRP) alpha and beta. The precise mechanism of action is unknown. It is the only approved anti-CGRP monoclonal antibody that can be given with a quarterly interval.
After subcutaneous injection, fremanezumab has a bioavailability of 55–66%. Highest concentrations in the body are reached after five to seven days. Like other proteins, the substance is degraded by proteolysis to small peptides and amino acids, which are reused or excreted via the kidney. The elimination half-life is estimated to be 30 to 31 days.
Fremanezumab was discovered and developed by Rinat Neuroscience, was acquired by Pfizer in 2006, and was then licensed to Teva. It was approved by the US Food and Drug Administration in September 2018. In March 2019, fremanezumab was approved for marketing and use in the European Union.
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