INDIVIDUAL CGRP ANTAGONISTS

AJOVY(Fremanezumab): Ajovy is a proven CGRP antagonist which was recommended by NICE for migraine prophylaxis(prevention). The precise mechanism of action by which Ajovy prevents migraine attacks is unknown. It is believed that prevention of migraine is obtained by its effect on modulating the trigeminal system. Ajovy was assessed by NICE , and it was the first CGRP migraine preventive therapy to gain a positive recommendation from NICE, and it was lately recommended for use in patients with either chronic migraine or episodic migraine. Ajovy was recommended as an option for preventing migraine in adults, only if:

1. They have 4 or more migraine days/month
2. At least 3 preventative drug treatments have failed.
3. The company provides it according to the commercial arrangement(patient access scheme).

AJOVY may need to be stopped 4 weeks after treatment if:

1. In episodic migraine(less than 15 headache days/month), the frequency does not reduce by at least 50%.
2. In chronic migraine(15 or more headache days/month with at least 8 of them have the classical features of migraine), if the frequency does not reduce by at least 30%.