What question did this study set out to answer?

To review the cardiovascular and cerebrovascular safety profile of CGRP-targeted migraine therapies in patients with preexisting vascular disease or major vascular risk factors.

June 19, 2025NeurologyOpen Access

CGRP-Targeted Migraine Therapies in Patients With Vascular Risk Factors or Stroke

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Authors

MEMichael Thomas Eller KSKatarína Schwarzová LGLena Gufler

Discussion

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Overview

Narrative review reveals limited safety data for CGRP-targeted migraine therapies in patients with vascular disease or stroke, highlighting the need for cautious decision-making.

Key Points

To review the cardiovascular and cerebrovascular safety profile of CGRP-targeted migraine therapies in patients with preexisting vascular disease or major vascular risk factors.
Synthesized findings from clinical trials and real-world safety studies of CGRP-targeted monoclonal antibodies and gepants compared with traditional migraine preventives.
Evaluated vascular safety in populations with prior stroke, subarachnoid hemorrhage, myocardial infarction, or severe cardiovascular comorbidities, including dual CGRP pathway blockade.
Found that while CGRP-targeted therapies demonstrate favorable cardiovascular safety in low-risk individuals, evidence remains critically scarce for patients with established vascular disease due to trial exclusion criteria.
Highlighted theoretical and clinical concerns regarding impaired vasodilatory defense mechanisms and established structured clinical considerations for using these therapies, including combination regimens, in high-risk patients.

Cite This Study

Eller et al. (2025) studied this question.

synapsesocial.com/papers/6a8a845ceeed409805de8ec7 https://doi.org/10.1212/wnl.0000000000213852

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June 19, 2025NeurologyOpen Access

CGRP-Targeted Migraine Therapies in Patients With Vascular Risk Factors or Stroke

View Full Paper

Ask AI

Bookmark

Authors

MEMichael Thomas Eller KSKatarína Schwarzová LGLena Gufler

Discussion

Member takes

Overview

Narrative review reveals limited safety data for CGRP-targeted migraine therapies in patients with vascular disease or stroke, highlighting the need for cautious decision-making.

Key Points

To review the cardiovascular and cerebrovascular safety profile of CGRP-targeted migraine therapies in patients with preexisting vascular disease or major vascular risk factors.
Synthesized findings from clinical trials and real-world safety studies of CGRP-targeted monoclonal antibodies and gepants compared with traditional migraine preventives.
Evaluated vascular safety in populations with prior stroke, subarachnoid hemorrhage, myocardial infarction, or severe cardiovascular comorbidities, including dual CGRP pathway blockade.
Found that while CGRP-targeted therapies demonstrate favorable cardiovascular safety in low-risk individuals, evidence remains critically scarce for patients with established vascular disease due to trial exclusion criteria.
Highlighted theoretical and clinical concerns regarding impaired vasodilatory defense mechanisms and established structured clinical considerations for using these therapies, including combination regimens, in high-risk patients.

Cite This Study

Eller et al. (2025) studied this question.

synapsesocial.com/papers/6a8a845ceeed409805de8ec7 https://doi.org/10.1212/wnl.0000000000213852

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