Volume 30, Issue 174, August 2026

Efficacy and safety of anti-calcitonin gene-related peptide monoclonal antibodies in episodic and chronic migraine prevention: A narrative review

Zuzanna Irzyk^1♦, Dominika Ruszel¹, Emilia Goc¹, Julia Rogała¹, Katarzyna Markuszka¹, Kinga Polityńska¹, Klaudia Samuła¹, Martyna Sarzyńska¹, Mateusz Szabat², Sylwia Lepak¹

¹Faculty of Medicine, Collegium Medicum, University of Rzeszów, Rzeszów, Poland
²Clinical Provincial Hospital No.2, Rzeszów, Poland

^♦Corresponding author
Zuzanna Irzyk, Faculty of Medicine, Collegium Medicum, University of Rzeszów, Rzeszów, Poland

ABSTRACT

Migraine is a common neurological disorder associated with substantial disability. Advances in understanding its pathophysiology have led to the development of therapies, such as monoclonal antibodies directed against calcitonin gene-related peptide (CGRP) or its receptor. This review focused on the efficacy and safety of anti-CGRP monoclonal antibodies in preventing episodic and chronic migraine. A PubMed search was performed for studies published from January 2016 to January 2026. Anti-CGRP monoclonal antibodies reduce monthly migraine days. They also improve responder rates compared with placebo, and they maintain generally favorable safety profiles. However, the treatment effect is moderate, and a substantial placebo response has been consistently observed across trials. Indirect evidence suggests broadly comparable efficacy among available antibodies, whereas the main differences relate to route of administration, dosing schedule, and tolerability. Anti-CGRP monoclonal antibodies are an important option in migraine prevention, especially for patients who do not respond to or cannot tolerate other preventive therapies. Further research is needed to better define their long-term safety and effectiveness compared with other treatments, and their optimal role in individualized treatment strategies.

Keywords: migraine, CGRP, erenumab, fremanezumab, galcanezumab, and eptinezumab.

Medical Science, 2026, 30, e141ms3874

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Published: 07 August 2026