{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T18:42:56Z","timestamp":1792176176844,"version":"4.4.0"},"reference-count":58,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2024,3,11]],"date-time":"2024-03-11T00:00:00Z","timestamp":1710115200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["headachejournal.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Headache"],"published-print":{"date-parts":[[2024,4]]},"abstract":"Abstract<\/jats:title>\n \n Objective<\/jats:title>\n To provide a position statement update from The American Headache Society specifically regarding therapies targeting calcitonin gene\u2010related peptide (CGRP) for the prevention of migraine.<\/jats:p>\n <\/jats:sec>\n \n Background<\/jats:title>\n All migraine preventive therapies previously considered to be first\u2010line treatments were developed for other indications and adopted later for migraine. Adherence to these therapies is often poor due to issues with efficacy and tolerability. Multiple new migraine\u2010specific therapies have been developed based on a broad foundation of pre\u2010clinical and clinical evidence showing that CGRP plays a key role in the pathogenesis of migraine. These CGRP\u2010targeting therapies have had a transformational impact on the management of migraine but are still not widely considered to be first\u2010line approaches.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Evidence regarding migraine preventive therapies including primary and secondary endpoints from randomized placebo\u2010controlled clinical trials, post hoc analyses and open\u2010label extensions of these trials, and prospective and retrospective observational studies were collected from a variety of sources including PubMed, Google Scholar, and ClinicalTrials.gov. The results and conclusions based upon these results were reviewed and discussed by the Board of Directors of The American Headache Society to confirm consistency with clinical experience and to achieve consensus.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n The evidence for the efficacy, tolerability, and safety of CGRP\u2010targeting migraine preventive therapies (the monoclonal antibodies: erenumab, fremanezumab, galcanezumab, and eptinezumab, and the gepants: rimegepant and atogepant) is substantial, and vastly exceeds that for any other preventive treatment approach. The evidence remains consistent across different individual CGRP\u2010targeting treatments and is corroborated by extensive \u201creal\u2010world\u201d clinical experience. The data indicates that the efficacy and tolerability of CGRP\u2010targeting therapies are equal to or greater than those of previous first\u2010line therapies and that serious adverse events associated with CGRP\u2010targeting therapies are rare.<\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n The CGRP\u2010targeting therapies should be considered as a first\u2010line approach for migraine prevention along with previous first\u2010line treatments without a requirement for prior failure of other classes of migraine preventive treatment.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/head.14692","type":"journal-article","created":{"date-parts":[[2024,3,11]],"date-time":"2024-03-11T09:15:24Z","timestamp":1710148524000},"page":"333-341","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":238,"title":["Calcitonin gene\u2010related peptide\u2010targeting therapies are a first\u2010line option for the prevention of migraine: An American Headache Society position statement update"],"prefix":"10.1111","volume":"64","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3379-054X","authenticated-orcid":false,"given":"Andrew C.","family":"Charles","sequence":"first","affiliation":[{"name":"Department of Neurology UCLA Goldberg Migraine Program Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2011-418X","authenticated-orcid":false,"given":"Kathleen B.","family":"Digre","sequence":"additional","affiliation":[{"name":"Departments of Neurology and Ophthalmology University of Utah Salt Lake City Utah USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3260-5904","authenticated-orcid":false,"given":"Peter J.","family":"Goadsby","sequence":"additional","affiliation":[{"name":"Department of Neurology UCLA Goldberg Migraine Program Los Angeles California USA"},{"name":"King's College London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5426-5333","authenticated-orcid":false,"given":"Matthew S.","family":"Robbins","sequence":"additional","affiliation":[{"name":"Department of Neurology Weill Cornell Medical College New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1598-7536","authenticated-orcid":false,"given":"Andrew","family":"Hershey","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and Neurology University of Cincinnati College of Medicine Cincinnati OH USA"},{"name":"Division of Neurology Cincinnati Children's Hospital Medical Center Cincinnati OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"The American Headache 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