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Study breakdown

Is the Migraine Drug Fremanezumab Safe for Patients with Multiple Sclerosis?

Animal StudyLow evidence
The takeaway

Fremanezumab reversed CGRP's anti-inflammatory effects in vitro but did not worsen disease progression in a mouse model of progressive MS.

2x migraine prevalence

Migraine is twice as common in MS patients compared to the general population

What the researchers found

Fremanezumab reversed CGRP's anti-inflammatory properties in vitro but did not worsen progressive MS disease course in mice.

Why it matters

MS patients with migraine need effective treatments — knowing that anti-CGRP drugs don't worsen MS removes a significant prescribing barrier.

The numbers in context

CGRP inhibited LPS-induced microglia activation and lymphocyte proliferation. Fremanezumab reversed these effects in vitro. NOD mice immunized with MOG35-55 for progressive EAE. Fremanezumab did not alter disease evolution.

How the study worked

Combined in vitro immunological assays and in vivo progressive EAE mouse model (NOD mice immunized with MOG35-55).

Who was studied

NOD mice with progressive EAE (MS model)

What this study cannot tell us

Mouse model of MS may not fully recapitulate human disease. Only one anti-CGRP antibody (fremanezumab) was tested.

How to read the evidence

Preclinical study with both in vitro and in vivo components — provides safety signals but cannot replace human clinical data.

When this study was published

Published in 2025, addressing an increasingly relevant clinical question as anti-CGRP drug use expands.

The bigger picture

This addresses a critical safety gap, supporting the potential use of anti-CGRP migraine therapies in the large population of MS patients with comorbid migraine.

Questions still open

  • Would longer treatment duration reveal delayed effects on MS?
  • Do other anti-CGRP antibodies (galcanezumab, erenumab) show similar safety in MS models?

Common questions

Can MS patients safely take anti-CGRP migraine drugs?
This mouse study found fremanezumab did not worsen MS progression, which is reassuring, but human clinical data is still needed for definitive safety guidance.
Why might anti-CGRP drugs be a concern in MS?
CGRP has anti-inflammatory properties, so blocking it could theoretically worsen autoimmune conditions like MS — this study suggests that concern may not apply in practice.

Read the original research

The anti-CGRP mAb Fremanezumab reverts the anti-inflammatory effects of CGRP in vitro but does not alter disease evolution in a mouse model of progressive multiple sclerosis.

European journal of pharmacology, 995, 177415

Citation

Pistolesi, Alessandra; Molli, Alice; De Cesaris, Francesco; Chiarugi, Alberto; Buonvicino, Daniela. (2025). The anti-CGRP mAb Fremanezumab reverts the anti-inflammatory effects of CGRP in vitro but does not alter disease evolution in a mouse model of progressive multiple sclerosis.. European journal of pharmacology, 995, 177415. https://doi.org/10.1016/j.ejphar.2025.177415