Review: An Update on CGRP Monoclonal Antibodies for the Preventive Treatment of Episodic Migraine.

Objective: CGRP targeting therapies have revolutionized the migraine preventive space, introducing novel migraine-specific therapies to improve headache care. Four monoclonal antibodies (mAbs) are approved for use in prevention of episodic migraines. Erenumab (AMG334), fremanezumab (TEV48125), and galcanezumab (LY2951742) are monthly subcutaneous injections, while eptinezumab (ALD403) provides an intravenous infusion option. This review aims to examine the clinical evidence for the safety and efficacy of CGRP-targeted mAbs in the prevention of episodic migraines with a focus on recent studies (2023-2024).

Results: Long-term studies reveal ongoing safety and efficacy in recent literature for all 4 monoclonal antibodies. These investigations have built evidence for earlier access to CGRP treatment as they increase quality of life and reduce monthly migraine days while being better tolerated than non-specific migraine preventative therapies. These studies support the recent 2024 AHS consensus statement recommending CGRP monoclonal antibodies be considered as first-line preventive treatment in episodic migraine.