Ajovy is a newer treatment option for Migraine prevention. Clinical studies and real-world feedback show it can reduce symptom days.
Ajovy, the first anti-CGRP treatment available at monthly and quarterly doses, has been on the market in several countries since 2018. New information about Ajovy’s effectiveness and its new injection method could mean good news for you and other people with Migraine.
Ajovy and Anti-CGRP — a Big Breakthrough
Before 2018, the only preventive treatments available were medications developed to treat other conditions, such as depression, high blood pressure, or seizures. Like a “hand-me-down” dress, a “hand-me-down” treatment might fit you really well … or not.
“Patients with Migraine have difficulty remaining on many Migraine preventive therapies for prolonged periods and persistence rates at 6 months are known to be quite low, with literature citing lack of efficacy and adverse events as the most common reasons for discontinuation,” said Peter J. Goadsby, MD, PhD, King’s College London, London, UK. (1).
In 2018, we finally got the big breakthroughs: the first generation of treatments created JUST for people with Migraine. These treatments block a protein called CGRP (calcitonin gene-related peptide), which is involved in Migraine attacks. By blocking the protein itself or the CGRP receptor, these anti-CGRP treatments block a critical step in the process that leads to Migraine attacks.
Ajovy (fremanezumab) manufactured by Teva, was approved in the U.S. in 2018 and in Europe in 2019 for the prevention of Migraine and Chronic Migraine. It’s one of four therapies for Migraine prevention targeting CGRP to be approved in the U.S. and Europe, along with Aimovig (from Amgen and Novartis), Emgality (from Eli Lilly), and Vyepti (from Lundbeck). Ajovy, Aimovig, and Emgality are injectable medications while Vyepti is a quarterly intravenous infusion.
Ajovy Now Easier to Use With Auto-Injector
When Ajovy first came on the market, it came in a pre-filled syringe, like you would see in a doctor’s office. Patients could take either one injection of 225mg each month or three injections totaling 675mg every three months. The other two anti-CGRP treatments designed for patients to use at home came in auto-injectors, like epi-pens. Syringes can be tricky for people to use if they don’t have experience giving injections.
In April 2020, Teva announced the release of Ajovy in an auto-injector, making it easier for people to use without a visit to a doctor’s office. The auto-injector was available in the U.S. and Germany right away, with plans to expand its availability to the rest of Europe and other countries later. People who were uncomfortable using the syringes may find Ajovy easier to try now.
Studies Show Ajovy Reduces Symptom Days
A year-long study following nearly 2,000 people using Ajovy after its approval confirmed that it worked well for many people and had few intolerable side effects.
“The low rates of discontinuation in this 12-month extension study due to lack of efficacy (4 percent of patients) or adverse events (3-5 percent of patients) suggest the potential that patients may be able to persist with this medication over a clinically relevant length of time,” said Dr. Goadsby. The study included people who had tried Ajovy in the original placebo-controlled clinical trials and people who were using it for the first time after it was approved.
- Nearly 8 out of 10 study subjects stayed on Ajovy for the entire year of the study, suggesting that the side effects were tolerable.
- People with Chronic Migraine who used Ajovy every three months saw a mean reduction of 7.2 days/month in severe Migraine attack days. Those who used Ajovy every month had a mean reduction of 8.1 days/month.
- More than half of those people with Chronic Migraine had a reduction of Migraine days of better than 50%.
- People with episodic Migraine using Ajovy quarterly saw a mean reduction of 5.2 days/month in Migraine attack days; those using Ajovy monthly had a similar reduction of 5.1 days/month.
The most common adverse events (AEs) were injection site reactions (26–33%); most were mild to moderate. Serious AEs occurred in 3% of patients, but study authors said those events appeared to be unrelated to treatment (2).
What the Migraine Community Says About Ajovy
On the Migraine Again Facebook page, people who tried Ajovy talked about their experiences with Ajovy.
Kristina S. had a great result:
It is amazing! It has completely changed my life after 30 years of migraines. This will not be the case for everyone. It took a few months to gradually work up to the results, so don’t take one shot and expect a miracle. Each month, things improved. But now, I can live a normal life again. For the first time. I can plan things. Sometimes I still get migraines, every once in a while. But I can take a few aspirin and then it’s gone in a few hours … Zero side effects as well. Besides the shot hurting.
Courtney S. had good results but changed from monthly to quarterly dosing:
It is the reason I can work again. The migraines are more controlled with Imitrex now. Years taking the abortive med and it stopped working. I could tell when I was due for Ajovy because the migraines would get worse. After about a year, Ajovy wasn’t as effective as in the beginning so now I do 3 shots at once and it lasts 3 months.
Angi G had mixed results:
On it currently. I still have daily headaches and bimonthly migraines, esp. around week 3. However, it has helped my vertigo, or ocular migraines according to my neurologist. So some improvement but not at all resolution as hoped.
Christie H. stopped taking Ajovy because of a side effect:
I tried Ajovy for 12 months, worked ok. It caused hair loss, which is reversing now that I’m not taking it.
How to Access Ajovy
According to a statement Teva released when Ajovy was approved in the U.S., its expected wholesale cost would be $575 per monthly dose and $1,725 per quarterly dose. That’s in the ballpark with the other anti-CGRP treatments.
Commercial insurances will often cover this medication, so many patients only need to pay a co-pay. And Teva has a savings program for eligible patients.
The Coalition for Headache and Migraine Patients (CHAMP) has published Financial Assistance Guides with a lot of valuable information on the different assistance programs available. CHAMP is based in the U.S. and their guides are best suited for an American audience. The Financial Assistance guides can help you navigate the various co-pay and assistance programs, at least in the short term.
Image: Getty Images
- Teva Pharmaceuticals. Press Release: First Long-Term Data on the use of AJOVY® (fremanezumab-vfrm) Injection in Patients with Migraine Published in Neurology. Business Wire. 15 Sept 2020