Monoclonal antibodies as migraine therapy.
DOI:
https://doi.org/10.70577/asce.v5i1.578Keywords:
Migraine Disorders; Antibodies, Monoclonal; Medication Therapy Management, Calcitonin Gene-Related Peptide.Abstract
Introduction: Migraine is a neurological disorder that can be disabling and is associated with a considerable individual and economic burden. Preventive treatments for this condition are often limited, which has encouraged the development of therapies targeting the calcitonin gene–related peptide (CGRP). The initiation of treatment with monoclonal antibodies appears to be a promising therapeutic alternative. Materials and Methods: A systematic descriptive bibliographic review was conducted using the following databases: PubMed, the Virtual Health Library, and SciELO. Studies published in English and Spanish, available in full text, peer-reviewed, and published between 2022 and 2025 were included. Article selection was performed following the PRISMA methodology, and 14 studies with the highest methodological quality were identified. Results: The evidence consistently showed that anti-CGRP antibodies promote a clinically significant reduction in monthly migraine days in both episodic and chronic migraine, a decrease in the use of medications associated with the acute phase, and a significant improvement in subjects’ quality of life. Discussion: The results of the present study indicate that all monoclonal antibodies demonstrate comparable efficacy, suggesting a class effect. The safety profile of this therapy appears favorable, and the extended dosing schedule seems to promote high treatment adherence. Conclusions: Anti-CGRP monoclonal antibodies represent a safe and effective preventive strategy for migraine, supporting their reasonable inclusion in current treatment algorithms.
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1. Ashina M, Katsarava Z, Do TP, et al. Migraine: epidemiology and systems of care. Lancet. 2022. Disponible en: https://pmc.ncbi.nlm.nih.gov/articles/PMC9997852/
2. Steiner TJ, Stovner LJ, Jensen R, et al. Burden of migraine and unmet needs in treatment. J Headache Pain. 2022;23:1–10. doi:10.1186/s40001-022-00716-w DOI: https://doi.org/10.1186/s40001-022-00716-w
3. Edvinsson L. The CGRP pathway in migraine as a viable target for therapies. J Headache Pain. 2023;24:94. doi:10.1186/s10194-023-01594-1 DOI: https://doi.org/10.1186/s10194-023-01594-1
4. Sacco S, Bendtsen L, Ashina M, et al. CGRP-targeted therapies and migraine pathophysiology. J Headache Pain. 2022;23:67. doi:10.1186/s10194-022-01431-x DOI: https://doi.org/10.1186/s10194-022-01431-x
5. Charles A. CGRP and migraine mechanisms. Neurology. 2023. Disponible en: https://pubmed.ncbi.nlm.nih.gov/41035604/
6. Dodick DW. Preventive migraine treatment strategies. Neurol Clin. 2023. Disponible en: https://pmc.ncbi.nlm.nih.gov/articles/PMC12483480/
7. NIHR Journals Library. Monoclonal antibodies for migraine prevention. Health Technol Assess. 2022;26:1–170. Disponible en: https://www.journalslibrary.nihr.ac.uk/hta/AYWA5297
8. Silberstein SD, et al. Patient-reported outcomes with CGRP monoclonal antibodies. Curr Med Res Opin. 2023. doi:10.1080/13696998.2023.2248842
9. Lipton RB, et al. Long-term safety and effectiveness of anti-CGRP therapies. Headache. 2024. Disponible en: https://pmc.ncbi.nlm.nih.gov/articles/PMC11810671/
10. Blumenfeld AM, et al. Real-world effectiveness of CGRP monoclonal antibodies. Cephalalgia. 2023. doi:10.1177/03331024231214987 DOI: https://doi.org/10.1177/03331024231214987
11. Ashina H, et al. Long-term outcomes with CGRP monoclonal antibodies. Cephalalgia. 2023. doi:10.1177/03331024231152169
12. Ferrari MD, et al. CGRP inhibition and migraine prevention. Cephalalgia. 2024. doi:10.1177/03331024241258734 DOI: https://doi.org/10.1177/03331024241258734
13. Tepper SJ, et al. Emerging data on CGRP monoclonal antibodies. Adv Ther. 2025. doi:10.1007/s12325-025-03348-8 DOI: https://doi.org/10.1007/s12325-025-03348-8
14. Goadsby PJ, et al. Clinical effectiveness of CGRP monoclonal antibodies in migraine. Front Neurol. 2024;1468961. Disponible en: https://www.frontiersin.org/articles/10.3389/fneur.2024.1468961
15. Ashina M, et al. Clinical response to CGRP monoclonal antibodies in episodic migraine. Front Neurol. 2023;1129439. Disponible en: https://www.frontiersin.org/articles/10.3389/fneur.2023.1129439
16. Ferrari MD, et al. Comparative effectiveness of CGRP-targeted monoclonal antibodies. J Headache Pain. 2024. doi:10.1186/s10194-024-01860-w DOI: https://doi.org/10.1186/s10194-024-01860-w
17. Blumenfeld AM, et al. Real-world outcomes of anti-CGRP monoclonal antibodies in refractory migraine. Cephalalgia. 2024. doi:10.1177/03331024241273966 DOI: https://doi.org/10.1177/03331024241273966
18. Tepper SJ, et al. Safety and treatment persistence of CGRP monoclonal antibodies in chronic migraine. BMJ Open. 2023;13:e068616. doi:10.1136/bmjopen-2022-068616 DOI: https://doi.org/10.1136/bmjopen-2022-068616
19. Russo A, et al. Predictors of response to anti-CGRP monoclonal antibodies. J Headache Pain. 2023. doi:10.1186/s10194-023-01602-4 DOI: https://doi.org/10.1186/s10194-023-01602-4
20. Lipton RB, et al. Sustained efficacy of CGRP monoclonal antibodies in migraine prevention. Headache. 2024. doi:10.1111/head.70012 DOI: https://doi.org/10.1111/head.70012
21. Minen MT, et al. Quality of life outcomes in patients treated with CGRP monoclonal antibodies. Medicina (Kaunas). 2023;59(9):1560. doi:10.3390/medicina59091560 DOI: https://doi.org/10.3390/medicina59091560
22. Al-Hashel JY, et al. Neurological adverse events associated with CGRP monoclonal antibodies. BMC Neurol. 2022. doi:10.1186/s12883-022-02774-3 DOI: https://doi.org/10.1186/s12883-022-02774-3
23. Silberstein SD, et al. Treatment discontinuation and tolerability of CGRP monoclonal antibodies. BMC Neurol. 2022. doi:10.1186/s12883-022-02714-1 DOI: https://doi.org/10.1186/s12883-022-02714-1
24. Ashina M, et al. Safety profile of CGRP-targeted therapies in migraine. J Headache Pain. 2022. doi:10.1186/s10194-022-01387-y DOI: https://doi.org/10.1186/s10194-022-01387-y
25. Vikelis M, et al. Long-term persistence with anti-CGRP monoclonal antibodies in real-world settings. Cephalalgia. 2023. doi:10.1177/03331024231152169 DOI: https://doi.org/10.1177/03331024231152169
26. Silberstein SD, et al. Patient-reported outcomes with CGRP monoclonal antibodies. Curr Med Res Opin. 2023. doi:10.1080/13696998.2023.2248842 DOI: https://doi.org/10.1080/13696998.2023.2248842
27. Tepper SJ, et al. Clinical outcomes associated with CGRP monoclonal antibodies in migraine prevention. Adv Ther. 2025. doi:10.1186/s13005-025-00494-w DOI: https://doi.org/10.1186/s13005-025-00494-w
28. Russo A, et al. Biomarker-based assessment of response to CGRP monoclonal antibodies. Front Neurol. 2024. Disponible en: https://pmc.ncbi.nlm.nih.gov/articles/PMC962396/
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Copyright (c) 2025 Tatiana Marisol Parra Sánchez, Luis David Silva García, Christian Giovanni Sánchez Sánchez, Grefa Molina Katherine Magaly, Johanna Stephanie Morales Ramírez
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