How Well Do Anti-CGRP Migraine Antibodies Work After Two Years?

Anti-CGRP monoclonal antibodies reduced monthly migraine days, disability scores (MIDAS and HIT-6), and acute medication intake over a 24-month period in 120 resistant migraine patients. At 6 and 12 months, 61% and 57% of patients respectively achieved at least 50% reduction in monthly migraine days. Medication overuse at baseline was identified as a significant negative predictor of treatment response (OR 0.23, 95% CI 0.07–0.74, p = 0.014).

Single-center retrospective study conducted from December 2019 to June 2023. Patients completed headache diaries tracking monthly migraine days, acute medication intake, and adverse events. Patient-reported outcomes included MIDAS and HIT-6 questionnaires. Responders (≥50% reduction in monthly migraine days) were compared to non-responders using logistic regression.

Most anti-CGRP clinical trials last 3–6 months. This study provides rare 2-year real-world data confirming these peptide-targeting antibodies maintain their effectiveness over time. The finding that medication overuse predicts poor response gives clinicians a practical screening tool before starting expensive biologic therapy.

CGRP-targeting therapies represent a major advance in migraine treatment. Long-term real-world data like this helps confirm that the benefits seen in clinical trials translate to sustained relief in everyday practice, especially for patients without medication overuse.

Single-center retrospective design limits generalizability. No control group or placebo comparison. Relatively small sample (120 patients). The study did not compare the three antibodies head-to-head. Patient self-reporting of migraine days introduces recall bias.