CGRP Antagonists Effective for Reducing Headache Days in People with Episodic/Chronic Migraine

Results from a retrospective cohort study presented at the 67th Annual Scientific Meeting of the American Headache Society (AHS) suggest that treatment with calcitonin gene-related peptide (CGRP) antagonists is effective for reducing headache days for people with episodic and chronic migraine. However, the study authors highlighted the need for improved data collection and patient monitoring to optimize treatment strategies. CGRP antagonists reviewed in the study included 1 receptor blocker, Aimovig (erenumab; Amgen Inc., Thousand Oaks, CA), and 2 ligand blockers, Emgality (galcanezumab; Eli Lilly and Company, Indianapolis, IN) and Vyepti (eptinezumab; Lundbeck, Copenhagen, Denmark).

The study analysis incuded the records of 132 individuals with migraine who received Aimovig, Emgality, and Vyepti between April 2021 and April 2024. Researchers assessed initial response rates for reduction in headache days, long-term outcomes, and the effects of switching therapies, while also identifying challenges in real-world data collection and patient follow-up.

Key findings include:

• For episodic migraine, Vyepti had the highest initial efficacy (83%) in reducing headache days, followed by Emgality (60%) and Aimovig (50%).
• For chronic migraine, Emgality had the highest initial efficacy (70%), followed by Vyepti (63%) and Aimovig (59%).
• Emgality showed long-term improvements, peaking at 27 months for episodic migraine and 33 months for chronic migraine. Vyepti and Aimovig lacked robust long-term data for analysis.
• Switching from Emgality to Vyepti maintained a 50% short-term efficacy, while switching from Emgality to Aimovig showed varied results.

Overall, CGRP antagonists are effective options for migraine management, but the authors recommend regular monitoring and standardized data collection to optimize care, as well as further head-to-head and longitudinal studies to clarify long-term efficacy. They emphasize the importance of tailoring therapy based on individual responses, given the variability in outcomes.

Source: Tanda O, Patel J, Lipnicka-Khan M. CACS: clinical advantages of cGRPi switch, a retrospective observational study. Presented at: Annual Scientific Meeting of the American Headache Society; June 19–22, 2025; Minneapolis, MN.