SynthesisClinical drug investigation2021
Comparative Efficacy of Oral Calcitonin-Gene-Related Peptide Antagonists for the Treatment of Acute Migraine: Updated Meta-analysis.
Synthesis in Clinical drug investigation, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
11 citing papers in PubMed, 2 syntheses or guidelines pooled it, 29 citations in OpenAlex.
- Safety and Efficacy of Calcitonin Gene-related Peptide Receptor Antagonists and Selective Serotonin Receptor Agonist in the Management of Migraine: A Systematic Review and Meta-analysis.CNS & neurological disorders drug targets · 2024Pooled it
- Effectiveness of Calcitonin Gene-Related Peptide Monoclonal Antibodies in the Prevention of Migraine: A Systematic Review and Meta-Analysis of Observational Cohort Studies.Clinical drug investigation · 2023Pooled it
- Monthly migraine days, tablet utilization, and quality of life associated with Rimegepant - post hoc results from an open label safety study (BHV3000-201).The journal of headache and pain · 2022Trial
- A Case of Acute Migraine Without Aura Treated With a New FDA-Approved Medication Ubrogepant.Cureus · 2024Article
- [New therapeutic era for migraine attacks with recently approved monoclonal antibodies, ditans and gepants].Revista de neurologia · 2024Review
- Review
- Novel Macrocyclic Antagonists of the CGRP Receptor Part 2: Stereochemical Inversion Induces an Unprecedented Binding Mode.ACS medicinal chemistry letters · 2022Article
- Trends in utilization and costs of migraine medications, 2017-2020.The journal of headache and pain · 2022Article
- New Approaches to Shifting the Migraine Treatment Paradigm.Frontiers in pain research (Lausanne, Switzerland) · 2022Review
- CGRP and Migraine: What Have We Learned From Measuring CGRP in Migraine Patients So Far?Frontiers in neurology · 2022Review
- A Comprehensive Review of Zavegepant as Abortive Treatment for Migraine.Health psychology research · 2022Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
objectiveThe calcitonin gene-related peptide (CGRP) is a new therapeutic target in migraine-a common disorder resulting in reduced quality of life. The aim of this study was to compare the clinical efficacy of five oral CGRP antagonists with that of a placebo and triptans against acute migraine via meta-analysis.
methodsSuitable randomized controlled trials (RCTs) were searched in PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Library, ClinicalTrials.gov, and World Health Organization International Clinical Trials Registry Platform (WHO-ICTRP) to compare the efficacy of oral CGRP antagonists with that of a placebo and triptans against acute migraine. Review Manager 5.4 was used for data analysis.
resultsA total of 17 trials met the eligibility criteria and were studied in detail. The CGRP antagonists were significantly more effective than the placebo with respect to outcomes such as pain freedom at 2 h post-dose (odds ratio = 2.11; 95% confidence intervals [CIs] = 1.90-2.35) and pain relief at 2 h post-dose (odds ratio = 1.94; 95% CIs = 1.70-2.21). Similar results were found in the subgroup analysis conducted to compare the clinical efficacy of the FDA-approved oral CGRP antagonists (ubrogepant and rimegepant) and placebo. However, the CGRP antagonists were less effective than the triptans with respect to outcomes such as pain freedom at 2 h post-dose (odds ratio = 0.66; 95% CIs = 0.55-0.78) and pain relief at 2 h post-dose (odds ratio = 0.78; 95% CIs = 0.66-0.93).
conclusionCGRP antagonists are more effective than placebo against acute migraine; however, further studies are required to consider CGRP antagonists as standard first-line treatment for acute migraine instead of triptans, especially in patients with co-existing cardiovascular diseases.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.