Meta-analysis of 11 long-term studies found anti-CGRP mAbs had only 3% adverse event-related discontinuation over ≥12 months, with 23% total discontinuation and no emergent safety signals.
3% stop from side effectsOnly 3% of patients discontinued anti-CGRP drugs due to side effects over 12+ months — very low for a preventive medication
What the researchers found
Over ≥12 months: 3% discontinuation due to AEs (vs 23% total discontinuation); AE rate >70% reported but stable/non-serious; no emergent safety signals; consistent across erenumab, fremanezumab, galcanezumab, eptinezumab.
Why it matters
Migraine is lifelong and requires long-term prevention. Confirming <3% AE-related discontinuation over 12+ months supports sustained use of these drugs.
How the study worked
Systematic review and random-effects meta-analysis of 14 records (11 studies) with ≥12 months anti-CGRP mAb use from PubMed, Cochrane, ClinicalTrials.gov (2013-2025), with ROBINS-I bias assessment.
What this study cannot tell us
All studies had severe risk of bias (observational designs). Heterogeneity in follow-up duration. Limited data for fremanezumab and galcanezumab specifically.
How to read the evidence
Meta-analysis of 11 long-term studies. Limited by observational designs and study-level bias, but consistent safety signal.
When this study was published
Published in 2025 with literature through April 2025.
The bigger picture
Long-term safety data is essential for lifelong therapy decisions. This meta-analysis fills a critical evidence gap for anti-CGRP drugs.
Questions still open
- Are there very rare long-term effects that these studies are too small to detect?
- Does the 23% total discontinuation include patients who improved and stopped?
- Would a registry-based study reveal additional safety signals?
Common questions
Are anti-CGRP migraine drugs safe long-term?
Do new side effects appear with long-term use?
Read the original research
Decoding the long-term safety of anti-CGRP (receptor) mAbs: a meta-analysis and systematic review.
The journal of headache and pain, 27(1), 10
Citation
Hoehne, Carolin Luisa; Overeem, Lucas Hendrik; Sanchez-Del-Rio, Margarita; Deligianni, Christiana; Gil-Gouveia, Raquel; Versijpt, Jan; Amin, Faisal Mohammad; Lampl, Christian; Ryliskiene, Kristina; Tronvik, Erling; Coppola, Gianluca; Holland, Philip R; MaassenVanDenBrink, Antoinette; Martelletti, Paolo; Reuter, Uwe. (2026). Decoding the long-term safety of anti-CGRP (receptor) mAbs: a meta-analysis and systematic review.. The journal of headache and pain, 27(1), 10. https://doi.org/10.1186/s10194-025-02256-0