A New Era in Migraine Therapy: Unpacking the Potentials of IV anti-CGRP monoclonal antibodies

Exploring the Key Considerations for Prescribing Anti-CGRPs – Advantages of Eptinezumbab


During The 3rd Abu Dhai Brain Conference held in Abu Dhabi, UAE (15 September 2023), the symposium titled " Exploring the Key Considerations for prescribing Anti-CGRPs – Advantages of Eptinezumbab " Professor Peter McAllister, MD, FAAN (Co-founder and Medical Director; New England Institute for Neurology and Headache, Stamford CT (USA); and Clinical Associate Professor, Yale University School of Medicine) explored the key considerations for prescribing anti-CGRPs after a short journey with the migraine world including its prevalence, burden, complications, and management.

A Holistic Lens: Determinants in Choosing Preventive Medications1

Choosing an appropriate preventive treatment for migraines requires a nuanced approach considering multiple vital factors. These encompass the patient's historical response to treatments, the provider's experiential insights, and the specific characteristics of the patient's headaches. Moreover, considerations surrounding childbearing potential, medication efficacy based on evidence, and the patient's preferences play significant roles. Additionally, a comprehensive evaluation of the patient's existing health conditions and medications, along with the potential tolerability of the treatment, are indispensable in making an informed and individualized decision. This multifaceted approach ensures a tailored and effective treatment plan, aiming to significantly enhance the patient's quality of life.

Harnessing the Power of Anti-CGRP Monoclonal Antibodies: A New Horizon in Migraine Prevention

The emergence of anti-CGRP monoclonal antibodies heralds a new era in the preventive treatment of migraines, offering renewed hope and enhanced options for adults grappling with this debilitating condition. Among these, Eptinezumab distinguishes itself by targeting the CGRP ligand and being administered through IV injection every 12 weeks, having received FDA approval in 2020 and EU nod in 2022. On the other hand, Erenumab, a proponent of the 4-week dosing regimen, focuses on the CGRP receptor and is administered subcutaneously, boasting approvals from both the FDA and the EU in 2018. Similarly, Fremanezumab, another warrior targeting the CGRP ligand, offers flexibility in dosing, with options for 4 or 12-week intervals, and has been embraced by the FDA in 2018 and the EU in 2019. Rounding off this formidable lineup is Galcanezumab, also focusing on the CGRP ligand and preferring a 4-week subcutaneous dosing approach, enjoying the green light from the FDA and EU in 2018. Together, these drugs represent a paradigm shift, offering personalized and effective strategies to manage migraines.


IV anti-CGRP monoclonal antibodies: Pioneering Speed and Sustained Efficacy in Migraine Management2,3

In the rapidly advancing field of migraine management, IV anti-CGRP monoclonal antibodies emerge as a trailblazer, engineered for a potent, swift, and prolonged response to migraine attacks. Their unique features are meticulously crafted to offer a sustained duration of action coupled with a rapid onset, setting a new benchmark in migraine treatments. Firstly, its highly selective binding attributes mean that it has been finessed to showcase high selectivity for the CGRP ligand, strategically designed to avoid off-target activities, thereby promising a treatment that is both targeted and minimizes potential side effects. Furthermore, its robust binding affinity characterizes a heightened affinity for the CGRP ligand, paving the way for a prolonged duration of action that ensures each administration continues to provide relief over an extended timeframe, acting as a resilient barrier against recurrent migraine onslaughts. Lastly, IV anti-CGRP monoclonal antibodies boast immediate bioavailability post-infusion, illustrating an impressive 100% bioavailability following IV administration and heralding a rapid onset of activity. This feature ensures that patients can expect prompt relief, facilitating a quicker path to recovery and improved quality of life. Together, these attributes spotlight IV anti-CGRP monoclonal antibodies as a formidable contender in the pursuit of efficient and lasting migraine management.



  1. Ailani J, Burch RC, Robbins MS; Board of Directors of the American Headache Society. The American Headache Society Consensus Statement: Update on integrating new migraine treatments into clinical practice. Headache. 2021;61(7):1021-1039.
  2. Garcia-Martinez LF, Raport CJ, Ojala EW, et al. Pharmacologic Characterization of ALD403, a Potent Neutralizing Humanized Monoclonal Antibody Against the Calcitonin Gene-Related Peptide. J Pharmacol Exp Ther. 2020;374(1):93-103.
  3. Baker B, Schaeffler B, Beliveau M, et al. Population pharmacokinetic and exposure-response analysis of eptinezumab in the treatment of episodic and chronic migraine. Pharmacol Res Perspect. 2020;8(2):e00567