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September 2018

Who Should Try New Antibody Treatments for Migraine?

Author Affiliations
  • 1Division of Headache, Department of Neurology, Brigham and Women's Hospital, Boston, Massachusetts
  • 2Harvard Medical School, Boston, Massachusetts
  • 3John R. Graham Headache Center, Department of Neurology, Brigham and Women's Hospital, Boston, Massachusetts
JAMA Neurol. 2018;75(9):1039-1040. doi:10.1001/jamaneurol.2018.1268

Four monoclonal antibodies (mAbs) are in development for the preventive treatment of migraine. If all goes well, the US Food and Drug Administration will approve more than one of them this year. Three target calcitonin gene–related peptide (CGRP),1 a widely distributed vasodilatory and modulatory neuropeptide that plays an important role in migraine. Another targets the CGRP receptor.1 When these antibodies become available, who should try them? How should physicians, patients, and payers weigh available information about efficacy in the context of uncertainty about long-term safety and likely high costs?

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