Study Analyzes Cardiovascular Risk Associated with Migraine Meds

The use of anti–calcitonin gene-related peptide (anti-CGRP) monoclonal antibodies (mAbs) as a treatment for migraine was not associated with an increased risk of cardiovascular events according to data published in JAMA Neurology. The findings of a retrospective, sequential cohort study of adult fee-for-service Medicare beneficiaries diagnosed with migraine addressed concerns about the potential cardiovascular risks of anti-CGRP mAbs due to the cardioprotective effects of CGRP.

The study analysis cohort included 9153 individuals with migraine obtained from Medicare administrative claims data from 2018 through 2020. Of these individuals, 5153 received treatment with anti-CGRP mAbs while 4000 received onabotulinumtoxinA treatment. Researchers performed statistical analysis to compare cardiovascular outcomes between the 2 treatment groups, with a primary endpoint of first myocardial infarction (MI) or stroke. Over a median follow-up of 4.3 to 4.4 months, the adjusted hazard ratios (aHRs) revealed no significant differences between those who received anti-CGRP mAbs and those who received onabotulinumtoxinA treatment in the primary endpoint of composite cardiovascular events (MI or stroke) or any of the key secondary endpoints:

• Composite CV events: aHR, 0.88 (95% CI, 0.44 to 1.77)
• Hyperintensive crisis: aHR, 0.46 (95% CI, 0.14 to 1.55)
• Peripheral revascularization: aHR, 1.50 (95% CI, 0.48 to 4.73)
• Raynaud phenomenon: aHR, 0.75 (95% CI, 0.45 to 1.24)

Subgroup analyses demonstrated that these findings were consistent across age groups (<65 or ≥65 years) and for patients with preexisting non-MI/stroke CV disease. The study authors note that further investigation is necessary to evaluate the potential for cardiovascular risk in other populations and over longer follow-up periods.