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April 4, 2026Neurology InternationalOpen Access

Comparing the Efficacy and Safety of Anti-CGRP Monoclonal Antibodies Versus Topiramate for Migraine Prophylaxis: Six-Month, Real-World, Intention-to-Treat Retrospective Evidence from the GRASP Study Group

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Authors

MVMichail VikelisDRDimitrios RikosAAAndreas A. Argyriou

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Overview

Retrospective study compares effectiveness and safety of two migraine prevention treatments, indicating a clear benefit for anti-CGRP monoclonal antibodies.

Key Points

  • The study aimed to compare the effectiveness and safety of anti-CGRP monoclonal antibodies against topiramate in migraine prevention.
  • Retrospective, intention-to-treat design from GRASP study group
  • Patients received fremanezumab, erenumab, galcanezumab, eptinezumab, or topiramate for at least six months
  • Outcomes included reductions in headache days, responder rates, medication intake, disability metrics, and quality of life scores
  • Mean monthly headache days decreased by −7.8 days with anti-CGRP antibodies vs. −3.8 days with topiramate (p < 0.001)
  • Higher responder rates were found across all anti-CGRP agents compared to topiramate
  • Anti-CGRP antibodies provided greater reductions in moderate/severe headaches, medication intake, and disability metrics
  • Better safety profile and lower discontinuation rates were observed for anti-CGRP antibodies compared to topiramate

Cite This Study

Vikelis et al. (2026) studied this question.

synapsesocial.com/papers/69d0afde659487ece0fa5fd9https://doi.org/10.3390/neurolint18040067
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Also Consider

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  1. 1Erenumab versus topiramate: migraine‐related disability, impact and health‐related quality of life2024 · 2 citations
  2. 2Treatment effectiveness of galcanezumab versus traditional oral migraine preventive medications at 3 months: Results from the TRIUMPH study2025 · 5 citations
  3. 3Critical reflections on medication overuse headache in patients with migraine: An unsolved riddle in nociception2025 · 4 citations
  4. 4Reliability of the Migraine Disability Assessment Score in A Population-Based Sample of Headache Sufferers1999 · 567 citations
  5. 5Headache Classification Committee of the International Headache Society (IHS) The International Classification of Headache Disorders, 3rd edition2018 · 10,876 citations