Newer migraine prevention medications offer modest benefit for chronic migraine: Study

A systematic review of randomized controlled trials evaluated the effectiveness and tolerability of pharmacologic prophylaxis for chronic migraines in adults. The review found that most calcitonin gene–related peptide (CGRP) targeted medications reduce migraine days by about two per month.

The review is published in Annals of Internal Medicine.

Researchers from McMaster University and colleagues reviewed 43 randomized clinical trials involving more than 14,700 adults comparing various pharmacologic interventions for chronic migraines with placebo.

They found that several newer drugs that target CGRP reduced monthly migraine days by about two days on average and were generally well tolerated. Evidence for older treatments, including botulinum toxin and some traditional oral medications, was weaker or showed higher rates of side effects.

The authors conclude that most CGRP‑targeted therapies are likely effective options for preventing chronic migraine, however, there are important limitations to consider. Effects of CGPR-targeted therapies are largely driven by industry-sponsored studies, warranting replication by independent investigators.

Additionally, more high-quality studies, including those assessing long-term safety, cost-effectiveness, and adherence, are needed for other treatments.

Reference:

Malahat Khalili, Faraidoon Haghdoost, Amin Liaghatdar, et al. Effectiveness and Tolerability of Pharmacologic Prophylaxis for Chronic Migraine: A Systematic Review of Randomized Controlled Trials. Ann Intern Med. [Epub 5 May 2026]. doi:10.7326/ANNALS-25-02221