Meta-analysis of randomized trials demonstrates that fremanezumab reduces monthly headache days in episodic migraine, indicating its value as an effective preventive therapy.
Key Points
To evaluate the efficacy and safety of fremanezumab as a preventive treatment for episodic migraine using synthesized evidence from randomized controlled trials.
Conducted a systematic review and random-effects meta-analysis following PRISMA guidelines (PROSPERO CRD420261385104) across PubMed, Embase, and Scopus through June 5, 2026.
Identified 4 placebo-controlled randomized controlled trials comprising 1,764 participants with episodic migraine and assessed risk of bias via the Cochrane RoB 2 tool.
Fremanezumab significantly increased the ≥50% responder rate compared to placebo (RR: 1.81, 95% CI: 1.53 to 2.15).
Monthly migraine days decreased significantly with fremanezumab (MD: -1.98 days, 95% CI: -2.93 to -1.03), alongside reductions in headache days, acute medication use, and migraine-related disability.
Incidence of treatment-emergent adverse events, serious adverse events, and discontinuations did not differ significantly from placebo, although injection-site induration occurred more frequently with fremanezumab.