Effectiveness of Calcitonin Gene-Related Peptide Receptor Antagonists for Migraine Treatment: A Meta-Analysis

Introduction: The pathophysiology of migraine has been researched incessantly, and it has been suggested that calcitonin gene-related peptide (CGRP) is associated with migraine attacks. CGRP receptor blockers are attracting attention as potential agents for migraine prevention and treatment of acute episodes. This meta-analysis aimed to assess the effects of available CGRP receptor antagonists, focusing on their therapeutic doses for acute migraine treatment. Methods: We systematically searched MEDLINE and Embase from inception to March 27, 2021, for English-language publications using the keywords "migraine " and "calcitonin gene-related peptide "; the searches were limited to human studies. Results: Five studies that focused on examining the effects of CGRP receptor antagonists on acute migraine treatment met the eligibility criteria for this meta-analysis. A pooled analysis demonstrated that CGRP receptor antagonists significantly increased freedom from pain (odds ratio [OR] = 2.066, 95% confidence interval [CI] 1.766-2.418, I-2 = 0%) and from bothersome symptoms in general (OR = 1.606, 95% CI = 1.408-1.830, I-2 = 0%); reduced the intensity of pain (OR = 1.791, 95% CI = 1.598-2.008, I-2 = 0%); and increased freedom from nausea (OR = 1.361, 95% CI = 1.196-1.548, I-2 = 0%) compared to a placebo. Conclusions: CGRP receptor antagonists are effective for acute migraine treatment and are expected to be used clinically as emerging therapeutic agents. (c) 2022 S. Karger AG, Basel