The first real-world Thai study of CGRP antibodies for migraine found that nearly 72% of patients achieved at least a 50% reduction in monthly migraine days over 6 months.
71.6% achieved ≥50% migraine reductionNearly three-quarters of Thai migraine patients on CGRP antibodies had their monthly migraine days cut in half or more within 6 months
What the researchers found
In the first real-world study of CGRP monoclonal antibody therapy from Thailand, 47 migraine patients (mostly using galcanezumab) showed strong responses over 6 months. At the 6-month mark, 89% had at least a 30% reduction in monthly migraine days, 71.6% achieved at least 50% reduction, and 58.5% achieved at least 70% reduction.
Monthly headache days decreased significantly over time (adjusted β = -0.42, p<0.001) and disability scores (MIDAS) also dropped significantly (adjusted β = -1.12, p=0.003). The response patterns were similar between patients with episodic migraine and chronic migraine, though episodic migraine patients had slightly higher response rates overall. Chronic migraine patients showed a steeper improvement trend in reducing abortive medication use.
Why it matters
Nearly all real-world data on CGRP antibodies for migraine comes from wealthy nations. This study fills an important gap by demonstrating that these peptide-targeting therapies work effectively in a Southeast Asian population — a region where migraine treatment options and clinical data have been limited. This matters for expanding access and informing treatment decisions in low- and middle-income countries where most of the world's migraine sufferers live.
The numbers in context
n=47 · 85.1% female · median age 37.2 years · 70.2% on galcanezumab · 89% achieved ≥30% MHD reduction at 6 months · 71.6% achieved ≥50% · 58.5% achieved ≥70% · p<0.001 for MHD decrease · p=0.003 for MIDAS improvement
How the study worked
This was a single-center retrospective chart review at a Thai medical center. Researchers reviewed records of 47 migraine patients who started CGRP monoclonal antibody therapy (70.2% galcanezumab) and tracked outcomes over 6 months. They measured monthly headache days, disability scores (MIDAS), and abortive medication use. Response rates were calculated at standard thresholds (30%, 50%, 70% reduction), and trends were compared between episodic and chronic migraine patients using adjusted regression models.
Who was studied
Thai adults with episodic or chronic migraine treated with CGRP monoclonal antibodies at a single center
What this study cannot tell us
The sample size of 47 is small, limiting statistical power for subgroup comparisons. As a single-center retrospective study, it is subject to selection bias and lacks a control group. The Thai population studied may not represent all Southeast Asian populations. Six months of follow-up is relatively short for assessing long-term efficacy and durability of response.
How to read the evidence
This is a small, single-center retrospective chart review without a control group. While the response rates are compelling, the sample size of 47 and observational design limit the strength of evidence. Its primary value is as a first-in-region real-world data point rather than definitive proof of efficacy.
When this study was published
Published in 2024 in The Journal of Headache and Pain. This is a very recent study addressing a current gap in the CGRP therapy literature.
The bigger picture
CGRP-targeting therapies have transformed migraine treatment in high-income countries, but their adoption in low- and middle-income nations has been slower due to cost and lack of local data. Studies like this one help build the evidence base that policymakers and insurance systems in these regions need to justify coverage and access. As more real-world data accumulates from diverse populations, it strengthens the case that CGRP peptide-targeting therapies represent a global advance in migraine care, not just a rich-country one.
Questions still open
- How do cost-effectiveness and accessibility of CGRP antibodies compare to existing preventive treatments in low- and middle-income Southeast Asian countries?
- Would larger, multi-center studies across Southeast Asia confirm these high response rates?
- Do genetic or lifestyle factors in Thai and Southeast Asian populations influence CGRP antibody response differently than in Western populations?
Common questions
What are CGRP antibodies and how do they prevent migraines?
Why does it matter that this study was done in Thailand?
Read the original research
Filling the data gap on CGRP mAb therapy in low- to middle-income countries in Southeast Asia: insights from a real-world study in Thailand.
The journal of headache and pain, 25(1), 150
Citation
Anukoolwittaya, Prakit; Hiransuthikul, Akarin; Pongpitakmetha, Thanakit; Thanprasertsuk, Sekh; Rattanawong, Wanakorn. (2024). Filling the data gap on CGRP mAb therapy in low- to middle-income countries in Southeast Asia: insights from a real-world study in Thailand.. The journal of headache and pain, 25(1), 150. https://doi.org/10.1186/s10194-024-01859-3