Date of Award
2026
Document Type
Capstone
Degree Name
Master of Science (MS)
Department
Physician Assistant Studies
Committee Chair
LaDonna Clark
Abstract
Introduction: Migraines are a disabling neurological condition affecting 12-15% of the population. Migraines are characterized by a unilateral throbbing headache lasting between 4 and 72 hours, often accompanied by photophobia, phonophobia, nausea, or vomiting. Until the approval of the first CGRP antagonist, Erenumab, in May 2018, the prophylactic treatment for migraines relied on non-migraine-specific medications, such as antihypertensives and antiepileptics. Studies have been done to determine the efficacy and safety of the new medications, but few have directly compared them to older non-migraine-specific medications used for prevention. The purpose of this paper is to compare the efficacy of CGRP antagonists to older and commonly prescribed prophylactic medications for the prevention of migraine.
Methods: A PubMed search using the keywords “migraine” AND “CGRP antagonists” AND [other prophylactic medications] AND “migraine prevention” with additional specifiers resulted in 17 articles. Five studies were selected for review after thorough evaluation of the content. These studies included four systematic reviews with meta-analyses and one randomized controlled trial (RCT) comparing the efficacy of the different medications.
Results: Results of the reviewed data favored the efficacy and tolerability of CGRP antagonists over other non-migraine-specific prophylactic medications for the prevention of migraines. The studies reported their results based on the reduction of monthly migraine days in the form of relative risk (RR), odds ratio (RR), or mean change from baseline.
Discussion: This review suggests that while the efficacy of the newer CGRP antagonists and the older commonly prescribed medications may be comparable, CGRP antagonists appear to be better tolerated. The improvement in tolerability would ultimately lead to increased compliance and a reduction of the migraine burden worldwide.
Recommended Citation
Hutto LC. The Efficacy of CGRP Antagonists versus Other Non-Migraine Specific Medications as Prophylactic Treatment for Episodic and Chronic Migraine. The PA Department Journal of Medical Science. 2025. https://digitalcommons.gardner-webb.edu/pa-department-journal-of-medical-science/33
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