Ajovy (fremanezumab-vfrm) is a brand-name biologic drug prescribed to help prevent migraine episodes in adults. It is a calcitonin gene-related peptide inhibitor (CGRP inhibitor) manufactured by Teva Pharmaceuticals. It is a monoclonal antibody that prevents headache pain from chronic or episodic migraine. It was approved in 2018 for the prevention of migraine in adults who have at least four migraine days per month. The drug is available as a 225 mg/1.5 mL single-dose injection in a prefilled syringe or autoinjector. The treatment has two dosing options at 225 mg administered monthly as one subcutaneous injection or 675 mg every three months administered as three subcutaneous injections. The medicine is administered via subcutaneous injection into areas like the stomach, upper thighs, or the back of the upper arms. It is used to treat migraines with or without aura (a warning sign, such as flashing lights, wavy lines, or spots). By taking Ajovy, you can reduce the number of migraine-free days each month, allowing you to reclaim your time with friends and family.
This article explores the potential connection between Ajovy and weight loss, addressing concerns and providing insights based on available data.
Ajovy and Weight Changes: What the Data Says
According to Lauren R. Natbony, MD, the Medical Director of Integrative Headache Medicine of New York and Assistant Clinical Professor of Neurology at the Icahn School of Medicine at Mount Sinai, weight loss is not a possible side effect of Ajovy. Weight gain has also not been reported as a side effect of Ajovy in clinical studies conducted by the manufacturer. The most common side effects are injection site reactions-including skin rash, itchy skin, and hives-after administering the dose of Ajovy from the prefilled syringe.
Potential Reasons for Weight Loss While on Ajovy
While Ajovy itself is not known to directly cause weight loss, some individuals might experience weight loss after starting Ajovy treatment. There are a few possible causes for this. Anyone experiencing rapid weight loss after starting Ajovy treatment should consult their healthcare provider.
Migraine Disorder and Body Weight
Ajovy doesn’t cause weight loss, but there is a connection between migraine disorder and body weight. Obesity is a risk factor for migraine, according to the American Migraine Foundation. Higher body mass index (BMI) has been found to be commonly associated with greater migraine prevalence and severity, as well as an elevated frequency of adverse effects (AEs).
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Dietary Migraine Triggers
Dietary migraine triggers can lead to nausea, which can impact your ability to eat a healthy, well-balanced diet. If you’re not sure which foods cause or worsen your migraine attacks, Dr. DeCaria suggests keeping a food journal. Ginger ale is a popular home remedy for nausea, but it is also a sugary soda drink with lots of extra calories. “Ginger is a low-calorie food: a teaspoon of fresh ginger contains about two calories, and a quarter-cup of sliced fresh ginger has about 24 calories,” she says.
Gastrointestinal Side Effects
Some people might experience weight loss on Ajovy because gastrointestinal side effects keep them from enjoying food as much as they usually do. Anyone concerned about weight changes while on Ajovy should get medical advice from their healthcare provider.
Lifestyle Changes
“Research supports that both ketogenic and low-calorie diets-1200 to 1500 [calories] per day-can significantly reduce the frequency of headaches,” says Morris. Physical activity burns calories, which can lead to weight loss for people who are overweight or with obesity. Exercising 30 to 60 minutes per day, three to four days per week, has been shown to reduce migraine headaches, says Dr.
Understanding Ajovy and How it Works
Ajovy is a humanized monoclonal antibody (mAb) that selectively targets the calcitonin gene-related peptide (CGRP). Your body has both CGRP and CGRP receptors. Doctors have found that CGRP attaches to a receptor and triggers migraine attacks. Ajovy works to block these receptors so the CGRP cannot attach to them. It helps to prevent migraine headaches by binding to the CGRP ligand to prevent receptor binding. Ajovy is in the class of medicines known as calcitonin gene-related peptide (CGRP) inhibitors.
Migraine headache pain is frequently described as an intense pulsing or throbbing pain in one area of the head. Additional symptoms include nausea and/or vomiting and sensitivity to light and sound. Migraine attacks may produce significant and potentially disabling pain for hours to days at time.
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Clinical Trial Data
The data presented at the European Headache Congress were from a post hoc analysis of the Phase 3 HALO-LTS1 and FOCUS2 trials, which evaluated the safety and efficacy of Ajovy at preventing migraine attacks in patients with obesity compared with individuals of normal weight over a period of six months. Obesity was defined as a body mass index (BMI) of ≥30 kg/m2 (BMI-high, 578 patients) with normal weight defined as a BMI of <30 kg/m2 (BMI-normal, 1859 patients).
The data show that at baseline, monthly migraine days in patients with obesity was 13.7 compared with 13.6 among normal weight patients. Further, after six months of treatment with Ajovy, monthly migraine days in obese patients dropped to 6.8 compared with 7.2 among normal weight patients. Additionally, AEs were similar among both patient cohorts administered Ajovy.
Important Considerations
It’s important to note that everyone’s body responds differently to medications. Someone else’s experience of a particular treatment may not reflect how your body will respond to it.
Side Effects of Ajovy
Ajovy can cause side effects that range from mild to serious. Its most common side effect is injection site reactions, such as skin discoloration, itching, or pain.
Ajovy may cause mild side effects, such as: injection site reactions (see “Side effects explained” for details) and high blood pressure. In most cases, these side effects are temporary, and some are easily managed. But if you have any symptoms that are ongoing or bother you, talk with your doctor or pharmacist. And do not stop using Ajovy unless your doctor recommends it.
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Serious side effects of Ajovy aren’t common, but can include: severe allergic reaction (see “Side effects explained” for details) and Raynaud phenomenon (reduced blood flow in the extremities, commonly the hands). If you develop serious side effects while using Ajovy, call your doctor right away. If they seem life threatening or you think you’re having a medical emergency, immediately call 911 or your local emergency number.
Alternatives to Ajovy
When it comes to migraine prevention, Ajovy is not the only option. “If weight changes are a concern, switching to Emgality or Vyepti may be a better option, as these medications work similarly to Ajovy but have potentially different side effect profiles,” says Dr. Natbony. “Gepants, such as Nurtec and Qulipta, are also good alternatives.
Additional Information
Ajovy was the second FDA-approved preventive migraine treatment in a new class of drugs that act by blocking the activity of CGRP, a molecule involved in migraine attacks. The first FDA-approved drug in this class was Aimovig (erenumab-aooe), which also gained approval in 2018.