The FDA has approved Ajovy, the second migraine prevention drug to hit the market this year. There are, however, concerns about cost.
A second wave of relief may be coming soon for people who suffer from migraine headaches.
The Food and Drug Administration (FDA) has recently approved a new drug that can significantly reduce migraine frequency.
It’s called Ajovy (fremanezumab), and it’s made by Teva Pharmaceuticals.
Ajovy is taken once per month or quarterly by injection, but it could set you back between $575 (monthly) and $1,725 (quarterly) per dose.
This is the second new migraine medication approved by the FDA this year. In May, the agency gave the green light to Aimovig, a drug designed to stop the painful headaches before they start.
By some estimates, migraine is the third most common disease in the world.
It’s more prevalent than diabetes, epilepsy, and asthma combined, according to The Migraine Trust.
Almost 15 percent of the world’s population experiences these headaches.
In addition, chronic migraine is experienced by nearly 2 percent of the global population. It ranks among the top 10 causes of disability.
The pain can last from hours to days at a time.
According to Dr. Howie Zheng, a neurologist at Mercy Medical Center in Maryland, migraine is more than just a headache.
People with the condition can experience disabling symptoms such as difficulty speaking, an aversion to light and noise, nausea, and vomiting.
Zheng adds that chronic migraine (eight attacks or more per month) disproportionately affects women.
“This could be because of monthly hormone changes. These attacks can happen around your monthly period, during pregnancy, and through menopause as well,” Zheng told Healthline.
Anyone who experiences migraines regularly finds out that different things can trigger an attack. Common triggers are caffeine, stress, and too little sleep.
However, some migraines may be caused by changes in brain chemistry or abnormal brain activity, while there is even a type of migraine that runs in families.
Ajovy is a new class of drug called an anti-calcitonin gene-related peptide antibody treatment (anti-CGRP).
Like Aimovig, it’s designed to prevent migraines from happening.
“Ajovy is part of a new class of CGRP-blocking medications that act on a completely new mechanism than previous treatments. CGRP is a protein fragment that can start and even prolong migraine episodes. Blocking it has been shown to reduce migraine frequency,” said Zheng.
According to recent research, when CGRP is released, it can cause severe inflammation in the coverings of the brain (meninges). For many people who experience migraines, this is what causes an attack.
Currently, there are two other anti-CGRP drugs in the pipeline: galcanezumab, made by Lilly, and eptinezumab, made by Alder BioPharmaceuticals.
Although anti-CGRP drugs won’t prevent all migraine attacks, they can reduce their frequency by up to 50 percent.
They can also make attacks that do occur less severe.
According to the nonprofit Institute for Clinical and Economic Review (ICER), patients they surveyed for a review of migraine drugs often discontinued or switched treatments due to lack of effectiveness or tolerability.
ICER reports that without adequate treatment, patients with episodic migraines are more likely to develop chronic migraine.
These treatments included antidepressants, hypertension drugs, and antiseizure medication. They came with side effects such as impaired cognition, sedation, weight gain, dry mouth, and sexual dysfunction.
However, according to Zheng, “Clinical trials show that this new class of medication has no more side effects than a placebo. The most serious problem that patients developed, according to the trial, was irritation at the injection site.”
CGRP plays a role in keeping the organs supplied with enough oxygen when blood flow is interrupted by stroke or heart attack.
It dilates blood vessels and is also important in regulating blood pressure and wound healing.
Blocking CGRP long term might interfere with these important processes, something that still isn’t known about this new class of drugs.
With any drug that has only been studied a short time with carefully chosen patients, there is a need to be cautious.
For example, experts recommend that women using this class of drugs not get pregnant until the substance is cleared from their body, a process that can take several weeks.
While the yearly cost of taking Ajovy is about $7,000 per year, this will typically be covered if you’re insured by any state or federally funded insurance programs.
Commercially insured migraine patients subject to copayments can visit the drugmaker’s website and register for a discount card.
This discount offer may cover up to 100 percent of their out-of-pocket costs.
CGRP-blocking drugs such as Ajovy have been shown in clinical trials to cut the frequency of migraine attacks by 50 percent while reducing the severity of those attacks.
The only side effect of Ajovy, revealed by clinical trials, was irritation at the injection site.
For people who need relief from chronic migraine attacks, this new treatment can add more pain-free days every month, improving their quality of life.