Published on
A systematic review of 43 randomized trials involving more than 14,000 patients found that evidence shows several newer calcitonin gene–related peptide (CGRP)-targeted drugs can reduce chronic migraine frequency by about 2 headache days per month compared with placebo. In the review published in the Annals of Internal Medicine, researchers also found the CGRPs may achieve at least a 50% reduction in migraine frequency, although those findings were sourced from a limited number of studies. Botulinum toxin produced a smaller reduction in monthly migraine days but was linked to more patients ending treatment because of side effects. The European Headache Federation and the American Headache Society recommend CGRP-targeted therapies as first-line options for migraine prevention, according to the authors.
Researchers found the drugs most likely to be helpful for chronic migraine prophylaxis included: eptinezumab; erenumab; fremanezumab; galcanezumab; and atogepant.
An option for acute episodes: Urgent care clinicians treating patients with acute migraine episodes may also consider greater occipital nerve block as a treatment option. Read more from the JUCM archive: Blocking the Pain: Nerve Block in the Treatment of Headache in Urgent Care