CGRP Therapies Reduced Migraine Days

By
Andrea Surnit
May 20, 2026

Conexiant

Overview

CGRP-targeted therapies significantly reduced monthly migraine headache days by approximately 2 days compared to placebo in patients with chronic migraine, based on a systematic review of 43 trials involving 14,725 patients, providing high-certainty evidence for several agents, highlighting their effectiveness and tolerability.

Background

Chronic migraine affects a substantial portion of the population, leading to significant disability and reduced quality of life. Traditional preventive treatments often have limited efficacy and tolerability, necessitating the exploration of new therapeutic options. CGRP-targeted therapies represent a novel approach to migraine prophylaxis, with emerging evidence supporting their use in clinical practice.

Data Highlights

Therapy	Reduction in Migraine Days	Certainty Level
Eptinezumab	~2 days	High
Erenumab	~2 days	High
Fremanezumab	~2 days	High
Galcanezumab	~2 days	High
Atogepant	~2 days	High

Key Findings

CGRP therapies reduced monthly migraine headache days by about 2 days compared to placebo.
High-certainty evidence supports the efficacy of eptinezumab, erenumab, fremanezumab, galcanezumab, and atogepant.
Fremanezumab and erenumab showed high-certainty evidence for achieving at least a 50% reduction in migraine days.
Galcanezumab likely reduced dropout rates due to any cause compared to placebo.
Erenumab and atogepant were associated with increased risks of constipation and nausea.
Botulinum toxin may slightly reduce migraine days but has low-certainty evidence and increased discontinuation due to adverse events.

Clinical Implications

CGRP-targeted therapies should be considered as first-line options for chronic migraine prevention due to their demonstrated efficacy and tolerability. Clinicians should remain aware of the potential side effects associated with these therapies, particularly gastrointestinal issues, and monitor patients accordingly.

Conclusion

CGRP-targeted therapies represent a promising advancement in the management of chronic migraine, offering significant reductions in headache days. Ongoing research is needed to evaluate long-term safety and effectiveness.