CGRP monoclonal antibody therapies are a new preventative treatment option for migraine. There are currently no existing treatments that eliminate migraine entirely, though these drugs have been shown in clinical trials to reduce migraine event frequency and severity in a moderate number of patients who experience frequent, disabling attacks. These medications are generally well tolerated, and are self injected on a regular schedule (monthly).

You should consider CGRP monoclonal therapy if you:

• are moderately to severely disabled by frequent migraine attacks
• have not benefited from existing treatments
• have difficulty tolerating existing migraine treatments

You should avoid these drugs if you:

• experience infrequent migraines and respond well to your existing treatment
• have cardiovascular disease, or are at high risk of heart disease or stroke
• are pregnant or trying to become pregnant
• suffer from severe constipation

Other issues to consider with CGRP monoclonal antibody therapy

The long term safety risks of this class of medication are still unknown.  If you are tolerating existing treatments and are satisfied with your control of migraines, this uncertainty needs to be kept in mind. In addition, patients with psychiatric or complex medical conditions were excluded from clinical trials, and it may not be appropriate to generalize the findings to patients with these co-morbidities.

Migraine is a complex disorder, and as can be seen, multiple factors need to be taken into account before any new treatment is prescribed. If you would like to be considered for this class of medication a discussion with a headache specialist is therefore advised to review your individual treatment suitability.

–Dr Nicole Limberg