CGRP Inhibitors Use in Migraine Patients Linked to Lower Glaucoma Risk: Study
Taiwan: A retrospective study involving 74,000 migraine patients found that people using calcitonin gene-related peptide (CGRP) inhibitors had a 25% lower risk of developing glaucoma within 3 years. The protective effect was seen only with monoclonal antibody CGRP inhibitors, while CGRP receptor antagonists did not show a similar benefit. Researchers hypothesized that CGRP inhibitors may help reduce glaucoma risk by regulating intraocular pressure.
The findings were published in the Neurology journal by Chien-Chih Chou and colleagues in a study titled Glaucoma Risk Associated With Calcitonin Gene–Related Peptide Inhibitor Use in Migraine.
Migraines have previously been associated with a higher likelihood of glaucoma, a progressive eye disease that can lead to vision loss if untreated. Calcitonin gene-related peptide inhibitors are increasingly used as preventive therapies for migraine, but their possible influence on glaucoma risk has remained unclear.
To explore this association, researchers conducted a multinational retrospective cohort study involving adults diagnosed with migraine between 2018 and 2024. Participants receiving preventive migraine medications were divided into two groups: those treated with CGRP inhibitors and those receiving non-CGRP preventive therapies such as topiramate, valproate, propranolol, metoprolol, amitriptyline, venlafaxine, and other commonly prescribed agents.
The study included 73,644 participants after propensity score matching in a 1:1 ratio. Patients were followed for up to three years to monitor the development of glaucoma. Researchers excluded treatment crossover to ensure clearer comparisons between the groups.
The researchers reported the following findings:
- Individuals using CGRP inhibitors had a significantly lower risk of developing glaucoma compared with those receiving non-CGRP preventive migraine medications.
- CGRP inhibitor users experienced an overall 25% reduction in glaucoma risk within three years of starting treatment.
- CGRP inhibitor therapy was associated with a lower glaucoma risk compared with several commonly used migraine preventive medications, including topiramate, valproate, propranolol, metoprolol, lisinopril, amitriptyline, and venlafaxine.
- The protective association against glaucoma was observed only with monoclonal antibody CGRP inhibitors such as erenumab, fremanezumab, galcanezumab, and eptinezumab.
- Oral CGRP receptor antagonists, including atogepant and rimegepant, did not show a statistically significant reduction in glaucoma risk.
- Reduced glaucoma risk associated with CGRP inhibitors was also seen in older adults, women, patients with chronic migraine, and individuals with migraine without aura.
According to the researchers, the findings suggest that systemic CGRP inhibition—particularly through monoclonal antibody therapies—may offer additional ocular benefits beyond migraine prevention. They proposed that CGRP blockade could potentially influence intraocular pressure regulation, which may contribute to the reduced risk of glaucoma.
The authors concluded that among adults receiving preventive migraine treatment, CGRP inhibitors were associated with a lower incidence of glaucoma compared with other preventive medications, warranting further investigation into the mechanisms underlying this relationship.
Reference:
Chou CC, Wu JW, Lin HJ, Wang IJ, Pan SY, Weng CH. Glaucoma Risk Associated With Calcitonin Gene-Related Peptide Inhibitor Use in Migraine: A Multinational Cohort Study. Neurology. 2026 Jun 9;106(11):e218035. doi: 10.1212/WNL.0000000000218035. Epub 2026 May 6. PMID: 42090640.
