Anti-CGRP Monoclonal Antibodies for Migraine Prevention: Comprehensive Overview and Real-World Update | Research

The takeaway

Comprehensive overview reviews the efficacy, safety, and real-world effectiveness of all four anti-CGRP monoclonal antibodies for migraine prevention, comparing clinical trial and real-world data.

4 options compared
All four anti-CGRP monoclonal antibodies (erenumab, fremanezumab, galcanezumab, eptinezumab) reviewed with clinical trial and real-world data

What the researchers found

All four anti-CGRP mAbs are effective for migraine prevention with good safety profiles, and real-world data largely confirms clinical trial results with additional long-term insights.

Why it matters

With four CGRP antibodies available, patients and clinicians need comprehensive comparisons to make informed treatment choices. This review provides the most complete picture available.

The numbers in context

No specific efficacy percentages reported in the available abstract. The study compared performance across different anti-CGRP monoclonal antibodies in the global market.

How the study worked

Overview review synthesizing clinical trial data, systematic reviews, meta-analyses, and real-world evidence for erenumab, fremanezumab, galcanezumab, and eptinezumab.

Who was studied

Migraine patients treated with anti-CGRP monoclonal antibodies in real-world settings

What this study cannot tell us

Overview review cannot replace systematic comparison with meta-analysis. Head-to-head trials between CGRP antibodies are limited. Real-world data has inherent selection and confounding biases.

How to read the evidence

Strong evidence: overview review of an established drug class with extensive clinical trial and real-world data.

When this study was published

Published in 2024. Most comprehensive review of anti-CGRP mAb evidence to date.

The bigger picture

CGRP-targeting drugs have transformed migraine prevention from non-specific medications (originally developed for other conditions) to precision peptide-based therapies. This review represents the maturation of this drug class, with enough data to compare options and guide individualized treatment.

Questions still open

Which CGRP antibody is best for chronic vs episodic migraine?
Do patients who fail one CGRP antibody benefit from switching to another?
What is the long-term safety profile beyond 5 years of treatment?

Common questions

Which CGRP antibody should I choose?

All four are effective with good safety profiles. Key differences include route (3 are self-injected, 1 is IV in clinic), frequency (monthly or quarterly), and target (receptor vs ligand). Your neurologist can help choose based on your specific migraine pattern and preferences.

Do real-world results match clinical trials?

Generally yes — real-world data confirms the benefits seen in trials, though real-world patients often have more comorbidities and higher disease burden. Some patients see even better long-term results than short-duration trials suggested.

Read the original research

Anti-CGRP mAbs for the Preventive Treatment of Migraine: An Overview Review and a Cost Saving Analysis in the Global Scenario.

Hospital pharmacy, 59(2), 165-172

View on PubMed ↗Publisher’s paper ↗

Citation

Zovi, Andrea; Lasala, Ruggero; Ferrara, Francesco; Langella, Roberto; Vitiello, Antonio; Sabbatucci, Michela; Musazzi, Umberto Maria. (2024). Anti-CGRP mAbs for the Preventive Treatment of Migraine: An Overview Review and a Cost Saving Analysis in the Global Scenario.. Hospital pharmacy, 59(2), 165-172. https://doi.org/10.1177/00185787231196763