CME 
JOBS 
OUTBREAKS 
PEER-TO-PEER 
QUIZZES & QUESTIONS 
MEDTECH 
Calcitonin gene-related peptide (CGRP) inhibitors represent a significant advancement in migraine prevention. This article provides a comprehensive overview of CGRP inhibitors, their efficacy in clinical trials, and potential off-target effects. It highlights the importance of understanding the wide-ranging actions of CGRP throughout the body and the need for long-term monitoring of patients using these medications.
Key Points:
- CGRP inhibitors, including monoclonal antibodies (erenumab, eptinezumab, fremanezumab, galcanezumab) and small molecule antagonists (gepants), have shown efficacy in reducing migraine days and improving quality of life in clinical trials.
- These medications are generally well-tolerated, with common side effects including constipation, injection site reactions, and fatigue.
- CGRP has numerous functions throughout the body, including roles in cardiovascular regulation, gastrointestinal function, and bone metabolism, raising concerns about potential long-term off-target effects.
- Special populations, such as those with medication overuse headache and episodic cluster headache, may benefit from CGRP inhibitors, but more research is needed.
- Caution is advised when prescribing CGRP inhibitors to patients with cardiovascular risk factors, gastrointestinal disorders, or impaired wound healing.
- Long-term monitoring is crucial to identify potential late complications, given CGRP’s widespread actions in the body.
- Real-world data will be valuable in comparing CGRP inhibitors to current therapies and exploring potential synergistic use with other preventative treatments.
HCN Medical Memo
Although CGRP inhibitors offer a promising new approach to migraine prevention, physicians should carefully weigh the potential benefits against possible long-term risks, particularly in patients with comorbid conditions affecting systems where CGRP plays a regulatory role.
More on Migraines/Headaches
