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Evidence to Practice
January 14, 2019

Calcitonin Gene-Related Peptide Monoclonal Antibody Treatments for Migraine

Author Affiliations
  • 1Division of Headache, Department of Neurology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
JAMA Intern Med. 2019;179(3):421-422. doi:10.1001/jamainternmed.2018.7536

The Institute for Clinical and Economic Review (ICER) has issued an evidence report on the effectiveness and value of 2 new calcitonin gene-related peptide monoclonal antibody treatments (CGRP mAbs) for migraine.1

Migraine is a disabling condition determined by both genetic and environmental factors. It affects an estimated 32 million people in the United States2 and produces a lifelong predisposition to develop severe headache and associated symptoms spontaneously or in response to triggers. Occasional migraine attacks usually are treated individually with symptomatic medications such as triptans. If attacks are frequent, regularly administered preventive treatment may decrease headache frequency or severity. A variety of US Food and Drug Administration–approved preventive treatments are available, including β-blockers such as propranolol, antiepileptic drugs such as topiramate, and biologics such as onabotulinumtoxinA. In general, these treatments provide modest relief of symptoms and some are poorly tolerated.3

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