The FDA has approved Ajovy, the second migraine drug to hit the market this year. There are concerns, however, about costs.
A second wave of relief could soon be coming for migraine sufferers.
The Food and Drug Administration (FDA) recently approved a new drug that can significantly reduce the frequency of migraines.
It's called Ajovy (fremanezumab) and is made by Teva Pharmaceuticals.
Ajovy must be taken once a month or quarterly, by injection, but it can cost you between $575 (monthly) and $1 (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 painful headaches before they start.
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A painfully common illness
By some estimates, migraine is the third most common disease in the world.
It's more common than diabetes, epilepsy and asthma combined, according to the Migraine Trust.
Nearly 15% of the world's population has these headaches.
Additionally, almost 2% of the world's population suffers from chronic migraine. It ranks among the top 10 causes of disability.
The pain can last for hours or days at a time.
According to Dr. Howie Zheng, a neurologist at Mercy Medical Center in Maryland, migraine is more than a headache.
Sufferers may experience disabling symptoms such as difficulty speaking, aversion to light and noise, nausea and vomiting.
Zheng adds that chronic migraine (eight or more attacks per month) disproportionately affects women.
“This could be due to monthly hormone changes. These attacks can occur around your period, during pregnancy, and during menopause,” Zheng told Healthline.
Anyone who suffers from migraines regularly discovers that different things can trigger an attack. Caffeine, stress and lack of sleep are common triggers.
However, some migraines can be caused by changes in brain chemistry or abnormal brain activity, while there is even a type of migraine that runs in families.
New type of drug
Ajovy is a new class of drugs called anti-calcitonin gene-related peptide-antibody (anti-CGRP) therapy.
Like Aimovig, it is designed to prevent migraines.
“Ajovy is part of a new class of CGRP-blocking drugs, which work through a completely new mechanism compared to previous treatments. CGRP is a protein fragment that can trigger and even prolong migraine episodes. Blocking it has been shown to reduce the frequency of migraines,” Zheng said.
According to recent research, when CGRP is released, it can cause severe inflammation of the linings of the brain (meninges). For many people who suffer from migraines, this is what causes an attack.
Currently, two other anti-CGRP drugs are in the works: galcanezumab, made by Lilly, and eptinezumab, made by Alder BioPharmaceuticals.
Although anti-CGRP medications do not prevent all migraine attacks, they can reduce their frequency by up to 50%.
They can also make attacks less severe.
Headaches may get worse
According to the nonprofit Institute for Economic and Economic Review (ICER), patients surveyed for a review of migraine medications often stopped or changed 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, blood pressure medications, and antiseizure medications. They came with side effects such as cognitive impairment, sedation, weight gain, dry mouth and sexual dysfunction.
However, according to Zheng, “clinical trials show that this new class of drugs has no more side effects than a placebo. According to the trial, the most serious problem patients developed was irritation at the injection site.
Effects of long-term use
CGRP plays a role in maintaining enough oxygen in the organs when blood flow is interrupted by a stroke or heart attack.
It dilates blood vessels and also plays an important role in regulating blood pressure and wound healing.
Blocking CGRP long-term could interfere with these important processes, something that is not yet known about this new class of drugs.
Regardless of which drug has been studied for a short time in carefully selected patients, you should exercise caution.
For example, experts recommend that women using this class of drugs not become pregnant until the substance is eliminated from their body, which process can take several weeks.
Ajovy is expensive, but there is help
Although the annual cost of taking Ajovy is about $7, it will usually be covered if you are insured by a state or federally funded insurance program.
Commercially insured migraine patients subject to supplemental payments can visit the drug manufacturer's website and sign up for a discount card.
This discount offer can cover up to 100% of their personal expenses.
The bottom line
Clinical trials have shown that CGRP-blocking drugs such as Ajovy reduced the frequency of migraine attacks by 50%, while reducing their severity.
Clinical studies found that the only side effect of Ajovy was irritation at the injection site.
For people who need relief from chronic migraine attacks, this new treatment can add more pain-free days each month, improving their quality of life.
