{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T01:18:06Z","timestamp":1780363086888,"version":"3.54.1"},"reference-count":34,"publisher":"American Medical Association (AMA)","issue":"7","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"Importance<\/jats:title>Calcitonin gene\u2013related peptide (CGRP), a neuropeptide involved in migraine pathophysiology, is also a key neuroimmune modulator. CGRP antagonists may help mitigate the hyperinflammatory response observed in patients with COVID-19; however, findings from the literature are contradictory, and to date, no study has investigated the safety and effectiveness of CGRP antagonists against COVID-19.<\/jats:p><\/jats:sec>Objective<\/jats:title>To evaluate the association between CGRP monoclonal antibody (mAb) treatment and risk of SARS-CoV-2 infection and sequela hospitalization, requiring supplemental oxygen, use of mechanical ventilation, or death.<\/jats:p><\/jats:sec>Design, Setting, and Participants<\/jats:title>This retrospective cohort study analyzed the electronic health records of US veterans aged 18 to 65 years who were diagnosed with migraine disorder and were at risk of COVID-19 between January 20, 2020, and May 19, 2022.<\/jats:p><\/jats:sec>Exposure<\/jats:title>Initiation of CGRP mAbs.<\/jats:p><\/jats:sec>Main Outcomes and Measures<\/jats:title>The main outcome was cumulative incidence of SARS-CoV-2 infection. Odds of 30-day hospitalization, requiring supplemental oxygen, use of mechanical ventilation, or death were secondary outcomes.<\/jats:p><\/jats:sec>Results<\/jats:title>Among 8\u202f178\u202f652 eligible person-trials (354\u202f294 veterans), 9992 (mean [SD] age, 46.0 [9.5] years; 53.9% male) initiated CGRP mAbs and 8\u202f168\u202f660 (mean [SD] age, 46.6 [10.2] years; 65.7% male) did not initiate CGRP mAbs. Over a 28-month follow-up period, 1247 initiators (12.5%) and 780\u202f575 noninitiators (9.6%) tested positive for SARS-CoV-2. After censoring persons who deviated from treatment, the incidence was 7.4 cases per 1000 person-months among initiators and 6.9 per 1000 person-months among noninitiators. The inverse probability\u2013weighted observational analogs of intention-to-treat and per-protocol hazard ratios were 0.95 (95% CI, 0.89-1.01) and 0.93 (95% CI, 0.86-1.02), respectively. No significant differences in the likelihood of hospitalization (odds ratio [OR], 0.93; 95% CI, 0.62-1.41), requiring supplemental oxygen (OR, 0.77; 95% CI, 0.45-1.30), use of mechanical ventilation (OR, 0.85; 95% CI, 0.26-2.84), or death (OR, 0.67; 95% CI, 0.09-5.23) were observed between CGRP mAb initiators and noninitiators who tested positive for SARS-CoV-2.<\/jats:p><\/jats:sec>Conclusions and Relevance<\/jats:title>In this cohort study, CGRP mAb treatment was not associated with positive SARS-CoV-2 test results or risk of severe COVID-19 outcomes, suggesting that CGRP mAbs may be used for migraine prevention during the COVID-19 pandemic. Given the few events of requiring supplemental oxygen, use of mechanical ventilation, and death, replication analysis in a larger sample of patients later in the course of disease is warranted.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2023.26371","type":"journal-article","created":{"date-parts":[[2023,7,31]],"date-time":"2023-07-31T15:33:59Z","timestamp":1690817639000},"page":"e2326371","source":"Crossref","is-referenced-by-count":7,"title":["Calcitonin Gene\u2013Related Peptide Monoclonal Antibodies and Risk of SARS-CoV-2 Infection and Severe COVID-19 Outcomes Among Veterans With Migraine Disorder"],"prefix":"10.1001","volume":"6","author":[{"given":"Kaicheng","family":"Wang","sequence":"first","affiliation":[{"name":"Research, Education, Evaluation and Engagement Activities Center for Headache, Headache Centers of Excellence, US Department of Veterans Affairs, Orange, Connecticut"},{"name":"Yale Center for Analytic Sciences, Yale School of Public Health, New Haven, Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brenda T.","family":"Fenton","sequence":"additional","affiliation":[{"name":"Research, Education, Evaluation and Engagement Activities Center for Headache, Headache Centers of Excellence, US Department of Veterans Affairs, Orange, Connecticut"},{"name":"Pain Research, Informatics, Multi-morbidities, and Education Center, VA Connecticut Healthcare System, West Haven"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanhong","family":"Deng","sequence":"additional","affiliation":[{"name":"Yale Center for Analytic Sciences, Yale School of Public Health, New Haven, Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah E.","family":"Anthony","sequence":"additional","affiliation":[{"name":"Research, Education, Evaluation and Engagement Activities Center for Headache, Headache Centers of Excellence, US Department of Veterans Affairs, Orange, Connecticut"},{"name":"Department of Neurology, Yale School of Medicine, New Haven, Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vinh X.","family":"Dao","sequence":"additional","affiliation":[{"name":"Headache Center of Excellence, VA Minneapolis Health Care System, Minneapolis, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emmanuelle","family":"Schindler","sequence":"additional","affiliation":[{"name":"Department of Neurology, Yale School of Medicine, New Haven, Connecticut"},{"name":"Headache Center of Excellence, VA Connecticut Healthcare System, West Haven"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard B.","family":"Lipton","sequence":"additional","affiliation":[{"name":"The Saul R. 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