Key clinical point: Network meta-analysis confirms the overall safety of anti-calcitonin gene-related peptide (CGRP) monoclonal antibodies and gepants for migraine prevention, with rare instances of treatment discontinuation.
Major finding: The risk for serious adverse events was not significantly different with active treatments and placebo, with 30 mg eptinezumab being the only treatment significantly associated with higher odds of adverse events leading to treatment discontinuation (odds ratio [OR] 2.62; 95% CI 1.03-6.66). Compared with placebo, the risk for treatment-emergent adverse events was not significantly different with 30 mg and 100 mg eptinezumab and was the highest with 240 mg galcanezumab (OR 1.63; 95% CI 1.33-2.00) and 120 mg galcanezumab (OR 1.40; 95% CI 1.16-1.70), with the most frequent being injection site erythema, induration, and pruritus.
Study details: The data come from a network meta-analysis of 19 phase 3 randomized controlled trials including 14,584 patients with migraine.
Disclosures: This study did not report the source of funding. The authors declared no conflicts of interest.
Source: Messina R et al. Safety and tolerability of monoclonal antibodies targeting the CGRP pathway and gepants in migraine prevention: A systematic review and network meta-analysis. Cephalalgia. 2023;43(3):3331024231152169 (Feb 14). Doi: 10.1177/03331024231152169