CGRP Antibodies for Migraine in Finland: Real-World Results from 383 Patients | Research

The takeaway

In a Finnish national survey of 383 migraine patients, CGRP monoclonal antibody treatment dramatically reduced monthly migraine days — from 74% having 12+ days to just 9% — while cutting sick leave and improving work capacity.

73.6% → 9.0%
The proportion of patients with 12+ monthly migraine headache days dropped from nearly three-quarters to under one in ten after CGRP antibody treatment

What the researchers found

Before CGRP mAb treatment, 73.6% of patients experienced 12 or more monthly migraine headache days; after treatment, only 9.0% did. Conversely, patients with 0-7 monthly migraine days went from 4.5% to 79.7%.

Monthly sick leave of 4+ days dropped from 37.0% to 4.0%. Full-time work/study capacity improved from 47.7% to 76.1%. Median pain intensity decreased from 8.0/10 to 6.0/10. Among the 383 respondents, 78 (20.4%) were on galcanezumab, the newest reimbursed CGRP mAb in Finland, and this group had more prior CGRP mAb switches suggesting they were harder-to-treat cases. Quality of life scores (MSQoL) did not differ between new users (0-6 months) and persistent users (6+ months), suggesting benefits are sustained.

Why it matters

Clinical trials showed CGRP antibodies work for migraine, but real-world data from actual patients — not selected trial populations — is essential for understanding true effectiveness. This survey shows that in everyday clinical practice in Finland, CGRP antibodies deliver transformative results for severely affected migraine patients. The improvements in work capacity and sick leave reduction also highlight the economic argument for these treatments.

How the study worked

This was a cross-sectional electronic survey distributed through Finnish community pharmacies and Migraine Finland (a patient advocacy group) in 2023. It included 383 adult users of subcutaneous CGRP monoclonal antibodies for migraine prevention. The survey captured monthly migraine headache days, sick leave, work/study capacity, pain intensity, treatment patterns, and quality of life (MSQoL questionnaire) before and after CGRP mAb treatment.

What this study cannot tell us

This was a cross-sectional survey relying on patient self-report and recall, which introduces recall bias. There was no control group, so improvements cannot be definitively attributed to CGRP mAb treatment alone. The survey was voluntary, potentially introducing selection bias toward satisfied patients. The before/after comparison was retrospective, not prospective. Specific CGRP mAb dosing details and duration of individual use were not detailed in the abstract.

How to read the evidence

This is a real-world cross-sectional survey with a moderate sample size (n=383). While it provides valuable evidence of effectiveness in routine clinical practice, the lack of a control group and reliance on retrospective self-report limit the strength of causal inference.

When this study was published

Published in 2025 using 2023 survey data, this study reflects the most current real-world experience with CGRP mAbs in Finland, where these treatments have been available and reimbursed for several years.

The bigger picture

CGRP-targeted therapies represent the first migraine treatments designed around the biological cause of the disease rather than borrowed from other conditions. This real-world evidence from Finland adds to the global picture that these peptide-targeted therapies are delivering on their clinical trial promise. The substantial reductions in disability and sick leave have implications for health economics and insurance coverage decisions, potentially justifying the high cost of these treatments through productivity gains.

Questions still open

How do these real-world Finnish results compare to outcomes in other healthcare systems with different CGRP mAb access policies?
Why did galcanezumab users have more prior CGRP mAb switches, and does this affect their long-term outcomes?
What is the economic impact of the sick leave reduction — does the productivity gain offset the cost of CGRP mAb treatment?

Common questions

What are CGRP antibodies and how do they prevent migraines?

CGRP (calcitonin gene-related peptide) is a neuropeptide that plays a central role in triggering migraine attacks — it causes blood vessels to dilate and nerves to become hypersensitive. CGRP monoclonal antibodies are laboratory-made proteins that block either CGRP itself or its receptor, preventing the peptide from triggering migraines. They are given as monthly or quarterly self-injections and are the first migraine preventives designed specifically around the biology of the disease.

How quickly do CGRP antibodies start working for migraine?

This survey found that quality of life scores were similar between new users (0-6 months) and long-term users (6+ months), suggesting benefits appear relatively early and are sustained. Many patients in clinical trials report improvement within the first month, with maximum benefits typically seen within 3 months of starting treatment.

Read the original research

A National Cross-Sectional Survey on Real-World Experiences of Calcitonin Gene-Related Peptide (CGRP) Monoclonal Antibody Use in Adults with Migraine in Finland.

Pain and therapy, 14(3), 1045-1061

View on PubMed ↗Publisher’s paper ↗

Citation

Casey, Caroline S; Pölkki, Mari; Suvanen, Elisa K; Iso-Mustajärvi, Ilona; Purmonen, Timo; Peltonen, Essi J; Appel, Camilla K; Patel, Niraj J; Von Arx, Lill-Brith. (2025). A National Cross-Sectional Survey on Real-World Experiences of Calcitonin Gene-Related Peptide (CGRP) Monoclonal Antibody Use in Adults with Migraine in Finland.. Pain and therapy, 14(3), 1045-1061. https://doi.org/10.1007/s40122-025-00719-5