A New Drug For The Prevention Of Migraine: Ajovy (fremanezumab)

Preventing migraine is a significant challenge for society as it is currently  one of the most common disabling illnesses. Ajovy (fremanezumab) is a new medicine and can therefore be very helpful in treating it.

Migraine isn’t just a headache – it’s a neurological disease. In Europe, more than 50 million people suffer from the consequences of this unpredictable disorder. It is a disease that greatly weakens patients, whether physically or psychologically. It is most common between the ages of 25 and 55  and has a big impact on the quality of people’s lives. Besides, it is more common in women and has a certain genetic component.

Migraine is recognized as an incapacitating disease. It is true that we are increasingly seeking to improve prophylaxis in order to be able to control it and reduce its impact, but very often migraine cannot be diagnosed and no adequate intervention is put in place.

New therapeutic alternatives, such as Ajovy, are fundamental to progress in the treatment of this disease. The prevention of migraine and symptomatic treatment are equally important in reducing the burden of this disorder in patients.

This new drug has been studied in patients with incapacitating migraine. Ajovy can thus reduce migraine days by 50%. Several studies validate its effectiveness as a preventive measure.

Another drug that has been used so far in migraine prophylaxis is propanolol. It is a relaxing medicine, marketed under the name Sumial, which is also used for anxiety.

What is Ajovy and how does it work?

Ajovy is the trademark of the monoclonal antibody fremanezumab. It is an injectable solution indicated for  the prevention of migraine in adults who suffer from it at least four days per month. It has been approved both in the United States and in Europe.

Fremanezumab is a humanized monoclonal antibody. It works by uniting with the peptide linked to the calcitonin gene (CGRP). It therefore prevents the latter from uniting with its receiver. This is why it is said to be an anti-CGRP. CGRP is one of the most abundant neuropeptides,  which occurs in both central and peripheral neurons. It is a powerful vasodilator, which has an influence on the transmission of pain.

CGRP levels have been shown to increase when suffering from migraine. When this neuropeptide is released in nerve endings and unites with its receptor, release of inflammatory mediators takes place, as well as potent vasodilation.

Therefore, by acting on CGRP,  fremanezumab would prevent the activation of the sensory fibers of the trigemine nerve, which are responsible for the activation of pain. However, the mechanisms of these substances are not yet fully understood.

Administration in the prevention of migraine

Ajovy is presented as a solution for injection, which is subcutaneous and easy to administer. Each pre-filled injection contains 225 milligrams of the antibody. It can be given in monthly or quarterly doses:

• If administered  monthly, a subcutaneous injection is sufficient.
• If administered  quarterly, three solutions should be injected at once. This would come down to 675 milligrams, which means that a dose should not be re-injected for three months.

This form of administration represents a great advantage as it increases the flexibility of the treatment. If one chooses the quarterly option, four administrations per year are sufficient  to follow the treatment well.

Side effects

The adverse reactions observed were generally mild. We have been able to detect  reactions in the skin around the injection site, such as:

• Pain
• Blushing
• Hardening
• Itching
• Eruption

However, since this is a new drug,  there is a need to continue to study its safety and long-term effectiveness. If you notice any side effects, consider going to see a specialist.

Note that not  all treatments work the same in all patients with migraine. Not all migraines are the same. There are different drugs and it is the specialist doctor who must adjust them to each specific case, by personalizing the treatment.

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