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

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

Pistolesi, Alessandra et al.·European journal of pharmacology·2025·lowAnimal StudyAnimal Study
RPEP-13065Animal Studylow2025RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Animal Study
Evidence
low
Sample
N=Not reported (mouse study)
Participants
NOD mice with progressive EAE (MS model)

What This Study Found

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

Key Numbers

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 They Did This

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

Why This Research Matters

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

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.

What This Study Doesn't Tell Us

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

Questions This Raises

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

Trust & Context

Key Stat:
2x migraine prevalence Migraine is twice as common in MS patients compared to the general population
Evidence Grade:
Preclinical study with both in vitro and in vivo components — provides safety signals but cannot replace human clinical data.
Study Age:
Published in 2025, addressing an increasingly relevant clinical question as anti-CGRP drug use expands.
Original Title:
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.
Published In:
European journal of pharmacology, 995, 177415 (2025)
Database ID:
RPEP-13065

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled Trial
Cohort / Case-Control
Cross-Sectional / Observational
Case Report / Animal StudyOne case or non-human subjects
This study

Tests effects in animals (usually mice or rats), not humans.

What do these levels mean? →

Frequently Asked 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 More on RethinkPeptides

Cite This Study

RPEP-13065·https://rethinkpeptides.com/research/RPEP-13065

APA

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

MLA

Pistolesi, Alessandra, et al. "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, 2025. https://doi.org/10.1016/j.ejphar.2025.177415

RethinkPeptides

RethinkPeptides Research Database. "The anti-CGRP mAb Fremanezumab reverts the anti-inflammatory..." RPEP-13065. Retrieved from https://rethinkpeptides.com/research/pistolesi-2025-the-anticgrp-mab-fremanezumab

Access the Original Study

Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.

This study breakdown was produced by the RethinkPeptides research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.