The monoclonal antibodies acting on the calcitonin gene-related peptide are the novel drugs which can be suggested for migraine prevention, as explained in 'The Journal of Headache and Pain'.

Four monoclonal antibodies have been developed, i.e., 1 targeting the calcitonin gene-related peptide receptor (erenumab) and 3 targeting the calcitonin gene-related peptide (eptinezumab, fremanezumab, and galcanezumab). The European Headache Federation (EHF) focused on providing an evidence-based and expert-based guideline explaining the use of the monoclonal antibodies acting on the calcitonin gene-related peptide to prevent migraine.

This guideline was made by using the Grading of Recommendation, Assessment, Development, and Evaluation (GRADE) approach. The working group recognised suitable questions, executed systematic review and analysis of the literature, evaluated the quality of available evidence, and composed the recommendations. Expert opinion should be used where the GRADE approach was not applicable.
Simona Sacco et al. found low to high-quality evidence supporting eptinezumab, erenumab, fremanezumab, and galcanezumab to recommend in patients suffering from episodic migraine. Medium to high quality of evidence to recommend erenumab, fremanezumab, and galcanezumab in patients with chronic migraine. For various clinical questions, there was not enough evidence to provide recommendations using the GRADE approach. The recommendations were based on experts’ opinion.

"Real life data will be useful to ameliorate the use of those drugs in clinical practice", concluded the working group.