Anti-CGRP therapies improved migraine duration, intensity, and associated symptoms in over 91% of adolescents and young adults aged 12-21 who had failed standard treatments, with 95.7% reporting no side effects.
91.3% improved with anti-CGRP therapyOver 9 in 10 adolescents and young adults with treatment-resistant migraines experienced reduced duration and intensity with anti-CGRP therapy, while 95.7% had no side effects.
What the researchers found
In 23 adolescents and young adults (ages 12-21) with treatment-resistant migraines:
- 91.3% experienced reduced migraine duration and intensity
- 82.6% reported improvements in other bothersome symptoms
- 73.9% had improved response to rescue medications
- 78.3% reduced rescue medication use by more than 50%
- 56.5% had fewer emergency room visits
- 82.6% had significant headache day reductions at 1 month, 87% at 3 months
- Nearly 40% had >50% reduction in headache days at both timepoints
- 95.7% reported no side effects
- 69.6% chose to continue treatment
Greatest benefits were in patients treated for >6 months. Most patients (78.3%) had chronic migraine.
Why it matters
Young people with chronic migraine face a double burden: the condition severely impacts their development, schooling, and mental health, while treatment options are limited — many medications are used off-label with significant side effects, and insurance denial rates are high. Showing that anti-CGRP therapies are both effective and well-tolerated in this age group provides crucial evidence for expanding access to these peptide-targeting treatments for young patients.
How the study worked
Retrospective study at a specialized pediatric headache center over 3 years. 23 patients ages 12-21 with migraine or chronic daily headaches unresponsive to standard treatments received anti-CGRP therapies: monoclonal antibodies (erenumab, fremanezumab, galcanezumab) and/or small-molecule CGRP receptor antagonists (ubrogepant, rimegepant, atogepant), sometimes combined with OnabotulinumtoxinA. Data were extracted from electronic medical records with structured visit templates. Patient satisfaction was assessed through telephone follow-ups and message reviews.
What this study cannot tell us
The sample size is very small (23 patients), severely limiting statistical power and generalizability. The retrospective design introduces potential selection and recall bias. There was no control group for comparison. The study was conducted at a single specialized center. Multiple different anti-CGRP agents were used, making it difficult to assess individual drug effects. Insurance coverage barriers may have introduced selection bias toward certain patient characteristics. Long-term safety data beyond the study period are not available.
How to read the evidence
This is a small retrospective study at a single center with no control group. While the results are encouraging, the very small sample size and observational design significantly limit the evidence strength. Larger, controlled studies are needed to confirm these findings.
When this study was published
Published in 2024, this study provides timely real-world data on anti-CGRP therapy use in younger patients, an area where evidence has been lacking compared to adult studies.
The bigger picture
Anti-CGRP therapies represent one of the most successful applications of peptide-targeted medicine, having transformed adult migraine treatment since their approval in 2018. Extending these benefits to adolescents and young adults is a natural progression, but the evidence base has been limited. This study, while small, adds important real-world data supporting the use of anti-CGRP drugs in younger patients — a population that stands to benefit enormously from effective, well-tolerated migraine prevention.
Questions still open
- Will larger randomized controlled trials confirm these results in adolescent and young adult migraine patients?
- Which anti-CGRP agent or combination is most effective for this age group?
- Can insurance coverage barriers for anti-CGRP therapies in young patients be addressed given this evidence?
Common questions
What is CGRP and why does blocking it help migraines?
Are anti-CGRP drugs safe for teenagers?
Read the original research
Effectiveness and Tolerability of Anti-Calcitonin Gene-Related Peptide Therapy for Migraine and Other Chronic Headaches in Adolescents and Young Adults: A Retrospective Study in the USA.
Brain sciences, 14(9)
Citation
Bandatmakur, Anjaneya Shankar Madhav; Dave, Pooja; Kerr, Melissa; Brunick, Colin; Wen, Sijin; Hansen, Nicholas. (2024). Effectiveness and Tolerability of Anti-Calcitonin Gene-Related Peptide Therapy for Migraine and Other Chronic Headaches in Adolescents and Young Adults: A Retrospective Study in the USA.. Brain sciences, 14(9). https://doi.org/10.3390/brainsci14090879