New publication on CGRP monoclonal antibodies for migraine and its effect on blood pressure

We are pleased to announce the publication of our article, “Blood pressure in migraine patients undergoing treatment with CGRP monoclonal antibodies: a systematic review and potential implications for clinical practice,” in the peer-reviewed journal Cephalalgia.

This systematic review provides a comprehensive analysis of the available literature on the effects of monoclonal anti-CGRP (receptor) antibodies on blood pressure. Our findings suggest that CGRP-targeting monoclonal antibodies may increase blood pressure (BP), with limited evidence indicating a mean rise of 5.2 mmHg in systolic BP. Given that even a 5 mmHg reduction in BP can lower the risk of stroke by 10%, this potential increase should not be overlooked.

Considering these potential risks, we recommend monitoring blood pressure before starting CGRP-targeted treatment and continuing every three months during the first year of therapy. If an increase in BP is detected, clinicians may consider prescribing candesartan, which not only helps lower blood pressure but has also shown effectiveness as a preventive treatment for migraine. While anti-CGRP(R)-mAbs are effective in migraine prevention, maintaining a balance between migraine treatment and cardiovascular safety is important—particularly since migraine patients already have a higher risk of cardio- and cerebrovascular disease compared to healthy individuals.

Since only four controlled studies have examined the impact of CGRP inhibitors on BP, further real-world data (RWD) is needed to evaluate cerebrovascular and cardiovascular safety.

📖 Read the full article here:

Britt W.H. van der Arend, Floor C. van Welie, Michael H. Olsen, Jan Versijpt, Antoinette Maassen Van Den Brink, and Gisela M. Terwindt

Tags: LUMC ; Erasmus MC; Holbaek Hospital, Denmark ; University of Southern Denmark ; Vrije Universiteit Brussel (VUB) ; Cephalalgia