SynthesisPain management2025
Repurposed versus disease-specific medicinals for the prophylaxis of migraine: an updated systematic review.
Synthesis in Pain management, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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
3 citing papers in PubMed.
- Number Needed to Treat and Cost Per Responder Analysis of Anti-CGRP Monoclonal Antibodies for Migraine Prevention in Adults for Whom Prior Preventive Treatments have Failed.Advances in therapy · 2025Trial
- 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.Neurology international · 2026Article
- Clinical and Genetic Factors Associated with Non-Response to Erenumab.Journal of clinical medicine · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundGepants, selective antagonists of the calcitonin gene-related peptide (CGRP) receptor, and monoclonal antibodies targeting CGRP or its receptor (anti-CGRP mAbs) are promising migraine treatments, demonstrating superior tolerability than traditional preventives. While their efficacy over placebo is established, their comparative benefit-risk profiles remain to be fully elucidated.
objectiveTo indirectly compare the benefit-risk ratios of gepants with anti-CGRP mAbs and repurposed preventives.
methodsA comprehensive search of PubMed/MEDLINE and ClinicalTrials.gov was conducted to identify phase-3, placebo-controlled trials of gepants (atogepant, rimegepant), anti-CGRP mAbs (eptinezumab, erenumab, fremanezumab, galcanezumab), and traditional treatments (propranolol, topiramate, onabotulinumtoxinA). The number needed to treat (NNT) for achieving ≥50% reduction in migraine days and the number needed to harm (NNH) for adverse effects were calculated to determine the likelihood to help versus harm (LHH) values.
resultsTwenty-seven studies were included: 15 of mAbs, 4 of gepants, 2 of onabotulinumtoxin A, and 6 of standard treatments. Atogepant and fremanezumab exhibited the highest LHH in episodic migraine, and galcanezumab and eptinezumab performed favorably in chronic migraine concerning treatment discontinuation and treatment-related adverse effects.
conclusionsAnti-CGRP/R medications present a more favorable benefit/risk ratio than traditional treatments. These findings, combined with individual patient histories and preferences, can inform clinical decision-making.
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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.