The role of CGRP monoclonal antibodies in migraine treatment – efficacy, safety, and perspectives for the future: a systematic review

Abstract

Background: Migraine is a widespread headache disorder occurring in every age group. It is divided into two types: chronic and episodic migraine. Many medications have been used in its treatment over the years with different degrees of effectiveness. In recent years, more attention has been given to the role of CGRP monoclonal antibodies for treatment, which are CGRP ligand antibodies (fremanezumab, galcanezumab, eptinezumab) and a CGRP receptor antibody (erenumab).Aim of the study: This study aimed to analyze the efficacy and safety of using CGRP monoclonal antibodies in migraine treatment and discuss CGRP’s role in migraine pathogenesis. Both chronic and episodic migraines were subjects of interest.Material and methods: The search was conducted using the PubMed database. We analyzed articles published in the years 2017–2022. The used keywords were “Migraine”, “Monoclonal antibodies”, “CGRP”, and “Calcitonin gene-related peptide”.Results: The number of articles found depended on the keyword used (“migraine” - 1875 results, “monoclonal antibodies” - 12173 results, “CGRP” - 352 results, and “calcitonin gene-related peptide” - 461 results). A total of 31 articles were quoted in this review. Positive results for treating migraines with CGRP ligand antibodies (fremanezumab, galcanezumab, eptinezumab) and CGRP receptor antibody (erenumab) were observed.Conclusions: The use of CGRP ligand and receptor antibodies seems promising for migraine therapy due to their relatively mild side effects and high efficiency.