CGRP Antagonists for Migraine: A Growing Drug Class

CGRP antagonists are a new class of drugs designed to prevent migraine headaches by targeting a key molecule involved in pain transmission.

Calcitonin gene-related peptide (CGRP) monoclonal antibodies, or CGRP antagonists, were the first class of

Before their existence, the other migraine preventive treatments were initially developed to treat other conditions (such as high blood pressure, depression, seizures), and then eventually used to treat migraine.

CGRP antagonists work by bringing down levels of

Active ingredient Drug name Year approved by the FDA Drug form erenumab Aimovig 2018 self-administered subcutaneous injection fremanezumab Ajovy 2018 self-administered subcutaneous injection galcanezumab Emgality 2018 self-administered subcutaneous injection rimegepant Nurtec ODT 2020 tablet that dissolves on or under your tongue ubrogepant Ubrelvy 2019 tablet that you swallow eptinezumab Vyepti 2020 in-office administered IV infusion atogepant Qulipta 2021 tablet that you swallow zavegepant Zavzpret 2023 nasal spray

For self-injected CGRP antagonists, the dosage and frequency of injection may vary depending on your symptoms and the specific medication.

A 2017 study found that fremanezumab (Ajovy) significantly reduced the frequency of headaches compared to a placebo over a 12-week trial in patients with chronic migraine.

In a 2017 study of erenumab (Aimovig), participants who took 70 mg or 140 mg subcutaneously experienced reduced migraine frequency and reduced effects of migraine on daily activities over 6 months.

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A 2019 study of rimegepant (Nurtec ODT) found a higher percentage of patients who were free of pain and free from their most bothersome symptom than placebo. Nurtec is also used to help

A 2019 study of ubrogepant (Ubrelvy) found that a greater proportion of participants who took ubrogepant experienced pain relief and absence of their most bothersome symptom within 2 hours, compared to those who received a placebo.

A 2021 study found that participants who took atogepant (Qulipta) orally once daily effectively reduced the number of migraine days and headache days over 12 weeks.

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These CGRP antagonists will continue to be researched and tested.

If you have chronic migraine, speak with your doctor about whether CGRP antagonists might help you find relief from symptoms.

The full effect of CGRP migraine treatments is still not completely understood. There may be long-term risks for some individuals, and more research is needed to better understand these medications.

So far, side effects such as drowsiness, nausea, dry mouth, abdominal pain, and upset stomach have been reported, though they tend to occur less frequently.

Some CGRP treatments are administered by injection, which may be painful. There’s also a risk of skin infection at the injection site. To reduce this risk, it’s important to wash your hands, clean the area, and use a new needle for each injection.

CGRP is also involved in widening blood vessels, which helps regulate blood pressure. Since these migraine treatments work by lowering CGRP levels, they may potentially affect blood pressure and heart function.

Since 2018, calcitonin gene-related peptide (CGRP) monoclonal antibodies, or CGRP antagonists, have emerged as an effective treatment for the prevention of migraine headaches.

CGRP antagonists work by blocking CGRP, which may cause pain in the nervous system of people with migraine.

Speak with your doctor if you think CGRP antagonists might help treat your migraine symptoms.