A victim of its own progress: why the success of modern therapeutics forces a re-evaluation of placebo-controlled trials in migraine prevention

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Migraine is a leading cause of disability worldwide, necessitating effective preventive treatments.
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The introduction of CGRP-directed therapies has shifted migraine prevention from empirical to mechanism-based approaches.
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Current ethical guidelines restrict placebo use in trials where effective treatments are available, raising ethical concerns.
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The American Headache Society now recommends CGRP therapies as first-line options for migraine prevention.
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Placebo controls in migraine prevention trials may pose ethical challenges due to the availability of effective treatments.

Frontiers In Neurology

by Nirit Lev, Leah Borovoi, Emily Elefant, Erel Domany, Oved Daniel, Gal Ifergane
July 9, 2026

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