Evidence map›Paper›PMID 41026450›Full record

SynthesisCNS drugs2026

Estimating Changes in Clinical Outcomes after Discontinuation of Anti-CGRP Targeting Therapy for Migraine Prophylaxis: A Systematic Review and Meta-analysis.

Luana Miyahira Makita, Thales Pardini Fagundes, Pedro Henrique Reginato, Lucca Passow Carpinelli, Giovanna de Freitas Morais, Renata Trinkel Montanarin, Rafael de Freitas Kleimmann, Rafael Eduardo Streit, Aishwarya Koppanatham, Andressa Christine Sales Rodrigues and 1 more

Abstract readSystematic ReviewMeta-Analysis
PubMed Publisher
In one paragraph

Synthesis in CNS drugs, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Luana Miyahira MakitaComplex of the Clinical Hospital of the Federal University of Paraná, General Carneiro Street, 181, Curitiba, Paraná, 80060-900, Brazil. makitaluana@gmail.com.ORCID 0009-0004-8728-1411
Thales Pardini FagundesHospital do Amor Barretos Cancer Hospital, Barretos, Brazil.ORCID 0000-0002-3302-9913
Pedro Henrique ReginatoComplex of the Clinical Hospital of the Federal University of Paraná, General Carneiro Street, 181, Curitiba, Paraná, 80060-900, Brazil.ORCID 0009-0004-3406-0770
Lucca Passow CarpinelliComplex of the Clinical Hospital of the Federal University of Paraná, General Carneiro Street, 181, Curitiba, Paraná, 80060-900, Brazil.ORCID 0009-0009-1454-1450
Giovanna de Freitas MoraisComplex of the Clinical Hospital of the Federal University of Paraná, General Carneiro Street, 181, Curitiba, Paraná, 80060-900, Brazil.ORCID 0009-0002-9068-1008
Renata Trinkel MontanarinComplex of the Clinical Hospital of the Federal University of Paraná, General Carneiro Street, 181, Curitiba, Paraná, 80060-900, Brazil.ORCID 0000-0001-7084-8443
Rafael de Freitas KleimmannComplex of the Clinical Hospital of the Federal University of Paraná, General Carneiro Street, 181, Curitiba, Paraná, 80060-900, Brazil.ORCID 0009-0007-9357-6381
Rafael Eduardo StreitComplex of the Clinical Hospital of the Federal University of Paraná, General Carneiro Street, 181, Curitiba, Paraná, 80060-900, Brazil.ORCID 0009-0007-6155-4006
Aishwarya KoppanathamAndhra Medical College, Visakhapatnam, India.ORCID 0009-0000-5737-4474
Andressa Christine Sales RodriguesComplex of the Clinical Hospital of the Federal University of Paraná, General Carneiro Street, 181, Curitiba, Paraná, 80060-900, Brazil.ORCID 0009-0000-6513-2408
Elcio Juliato PiovesanNeurology Service, Department of Clinical Medicine, Complex of the Clinical Hospital of the Federal University of Paraná, Curitiba, Brazil.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

objectivesAnti-calcitonin gene-related peptide (CGRP) therapies have significantly improved migraine prevention, but the long-term impact of discontinuation remains unclear. This systematic review and meta-analysis aimed to evaluate clinical outcomes following the cessation of anti-CGRP therapy.

methodsPubMed, Embase, and Cochrane databases were searched up to September 2024 for randomized or observational studies reporting post-discontinuation effects in patients with episodic or chronic migraine who had been preventively treated with anti-CGRP monoclonal antibodies or gepants. The primary outcome was the mean change in monthly migraine days from baseline to post-discontinuation. Secondary outcomes included acute headache medication use, the mean change in migraine frequency from active therapy to treatment cessation, and ≥ 50% responder rates. Heterogeneity was assessed with prediction intervals (PIs) for binary outcomes and I

resultsEight studies (n = 1012) evaluating anti-CGRP monoclonal antibodies interruption were included. No studies on gepant cessation were found. Monthly migraine days decreased significantly post-discontinuation compared with baseline (MD -3.78; 95% CI -4.89, -2.67; I

conclusionsMigraine burden worsened after discontinuation of anti-CGRP targeting therapies but remained lower than pretreatment levels. Further research is needed to explore disease-modifying potential and optimal discontinuation strategies. PROSPERO registration number CRD42024595771.

Indexed as

Antibodies, MonoclonalCalcitonin Gene-Related PeptideMigraine DisordersHumansRandomized Controlled Trials as TopicTreatment OutcomeAntibodies, MonoclonalCalcitonin Gene-Related Peptide

Identifiers

PMID41026450

What OpenQuestion holds

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Registered trials

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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.