A literature review published in Headache on anti-calcitonin gene-related peptide (CGRP) therapies for the treatment of headache sought to provide an update reflecting new information that was presented at the American Headache Society 60th Scientific meeting, held in San Francisco, California, June 28 to July 1, 2018.

Since the previous review on the topic was published, the US Food and Drug Administration has approved 3 new anti-CGRP ligand monoclonal antibodies (MAB) for the prevention of migraine. These therapies are: erenumab-aooe, a fully human MAB that targets the canonical CGRP receptor and is available in the form of autoinjectors with monthly subcutaneous doses of 70 or 140 mg; fremanezumab-vfrm, a fully humanized MAB that targets the CGRP ligand and is available in prefilled syringes of 225 mg (monthly subcutaneous dose of 225 mg or quarterly dose of 675 mg); and galcanezumab-gnlm, a humanized MAB that targets the CGRP ligand and is available both as an autoinjector or prefilled syringe (120 mg dose).

Several other trials have revealed important findings with immediate clinical implications. Three erenumab pivotal trials, 2 fremanezumab pivotal trials, and 2 of the 3 Phase 3 galcanezumab trials are now published. Galcanezumab was found to be effective in preventing episodic cluster headache. Fremanezumab treatment was found to convert chronic migraine to episodic migraine. Erenumab was found to be effective in converting individuals overusing the medication who stay on the biologic to non-overusers across time.

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The author acknowledges several potential conflicts of interest; please see original reference for a full list of author’s disclosures.


Tepper SJ. Anti-calcitonin gene-related peptide (CGRP) therapies: update on a previous review after the American Headache Society 60th Scientific Meeting, San Francisco, June 2018Headache. 2018; 58:276-290. doi:10.1111/head.13417