In adults, galcanezumab was found to be more effective in comparison with verapamil and other therapies as a prophylaxis therapy to decrease episodic cluster headache attacks. 

A systematic literature review and network meta-analysis of randomized controlled trials (RCTs) were carried out to investigate the efficacy of galcanezumab (a humanized monoclonal antibody) vs. other drugs to treat episodic cluster headache.

Databases such as Embase, MEDLINE, and Cochrane Library including RCTs and observational studies were explored. The alteration from the baseline in minimizing attacks of episodic cluster headache while the proportion of responders was utilized to pairwise comparisons of the observational studies was the primary endpoint.

The network meta-analysis was carried out utilizing a random-effects model and fixed-effect model with deviance information criterion stated for both the models. For the model having the lower deviance information criterion, the surface under the cumulative ranking (SUCRA) was demonstrated.

In the systematic literature review, 3 RCTs and 6 observational studies were incorporated. The Bayesian network meta-analysis was performed on the two RCTs incorporated in the systematic literature review, particularly verapamil and galcanezumab studies.

SUCRA demonstrated that galcanezumab had the highest probability of being the most effective therapy (probability = 66.33%) in comparison with placebo (probability = 2.09%) and verapamil (probability = 31.58%). Galcanezumab was found to have the greatest overall probability to be the 2^nd most effective therapy (probability = 88.79%).

Galcanezumab appears to be a valuable preventive therapy for episodic cluster headache people. Additional head-to-head RCTs of galcanezumab vs. other therapies are required to better explore its benefit-risk profile and comparative efficacy.