Systematic Review of Pharmacologic Treatment for Migraine Prevention in Adults: Report of the AAN Guidelines Subcommittee and the American Headache Society.
NeurologyAug 31, 2026 (epub)
Clinical ResearchNeurology
Tamara Pringsheim, Don B Smith, Sarah Tanveer et al.
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In 30 seconds
This systematic review evaluated pharmacologic treatments for migraine prevention in adults, analyzing 217 randomized controlled trials. High-confidence evidence indicated that galcanezumab and erenumab significantly reduce headache frequency in episodic migraine compared to placebo. The findings aim to inform updated practice guidelines by the AAN and American Headache Society.
Key findings
- High-confidence evidence showed galcanezumab and erenumab are more effective than placebo for episodic migraine.
- For chronic migraine, fremanezumab, galcanezumab, and onabotulinumtoxinA significantly reduced headache frequency.
- Erenumab, fremanezumab, and galcanezumab improved patient-reported quality of life outcomes across both migraine types.
- Evidence comparing active treatments was limited and generally of low or very low confidence.
Why it matters
Understanding the efficacy of various pharmacologic treatments for migraine prevention is crucial for clinicians to make informed decisions about patient care. This review consolidates evidence to guide treatment selection, potentially improving patient outcomes.