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CGRP-targeted medication in chronic migraine - systematic review.

Renato Oliveira1,2, Raquel Gil-Gouveia3,4, Francesca Puledda5

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Calcitonin gene-related peptide (CGRP) targeted therapies are effective for chronic migraine management, reducing migraine days and medication overuse. These treatments demonstrate a favorable safety profile in clinical trials and real-world data.

Keywords:
CGRPChronic migraineMedication overuseMigraineanti-CGRP

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Area of Science:

  • Neurology
  • Pharmacology

Background:

  • Chronic migraine is a debilitating neurological disorder.
  • Managing chronic migraine is challenging, especially with medication overuse headache.
  • Calcitonin gene-related peptide (CGRP) pathway inhibitors show promise for treatment.

Purpose of the Study:

  • To review randomized clinical trials and real-world studies on CGRP-targeting medications for chronic migraine.
  • To evaluate the efficacy and safety of CGRP inhibitors in chronic migraine patients.

Main Methods:

  • Searched PubMed and Embase for relevant studies.
  • Included randomized clinical trials and real-world studies.
  • Conducted a qualitative analysis of 19 selected studies.

Main Results:

  • Anti-CGRP monoclonal antibodies (mAbs) reduced monthly migraine days by 50% in 27.6-61.4% of patients.
  • 40.88% converted from chronic to episodic migraine; 29-88% ceased medication overuse.
  • Obesity is a negative predictor; no single anti-CGRP mAb showed superiority. Gepants also demonstrated efficacy.

Conclusions:

  • CGRP-targeting drugs are safe and effective for chronic migraine.
  • Strong evidence supports their use based on clinical trials and real-world data.