Evidence map›Paper›PMID 41546694›Full record

SynthesisEuropean journal of clinical pharmacology2026

Efficacy and safety of CGRP monoclonal antibodies for migraine prevention in episodic migraine; a network Meta-analysis.

Ishwa Shakir, Faizan Shahzad, Ahsan Shabbir, Saba Shahabuddin, Haroon Shabbir, Sobia Karamat, Saad Hulou, Abdul Rauf Khalid, Syed Ijlal Ahmed

Abstract readNetwork Meta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in European journal of clinical pharmacology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.

0numbers the graph read from it
0cells of the map it votes in
9citing 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

9 citing papers in PubMed.

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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

9 authors.

Ishwa ShakirCollege of Medicine, Islamic International Medical College, Rawalpindi, Pakistan.
Faizan ShahzadCollege of Medicine, Rawalpindi Medical University, Rawalpindi, Pakistan.
Ahsan ShabbirCollege of Medicine, United Medical and Dental College, Karachi, Pakistan.
Saba ShahabuddinCollege of Medicine, Jinnah Sindh Medical University, Karachi, Pakistan.
Haroon ShabbirCollege of Medicine, Islamic International Medical College, Rawalpindi, Pakistan.
Sobia KaramatDepartment of Ophthalmology, Amir Eye Hospital, Rawalpindi, Pakistan.
Saad HulouCollege of Medicine, University of Aleppo, Aleppo, Syria. Saad.Hulou98@gmail.com.
Abdul Rauf KhalidCollege of Medicine, Bahria International Hospital Orchard, Lahore, Pakistan.
Syed Ijlal AhmedDepartment of Neurology, Saint Louis University School of Medicine, St. Louis, MO, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

background and purposeEpisodic migraine is a neurological disorder characterized by recurrent, unilateral headaches that significantly impair quality of life. CGRP monoclonal antibodies, targeting calcitonin gene-related peptide (CGRP), have shown efficacy in preventing and treating episodic migraine.

methodsA systematic search of PubMed, Cochrane, and Embase databases was conducted in September 2024 to identify randomized controlled trials (RCTs) on CGRP monoclonal antibodies for episodic migraine. A network meta-analysis was performed to assess efficacy (change in monthly migraine days) and safety (incidence of adverse events). Odds ratios (ORs) and surface under the cumulative ranking curve (SUCRA) were calculated.

results16 studies with 9,123 participants were included. galcanezumab (240 mg) showed the highest efficacy (SMD = 0.5012, p < 0.0001). fremanezumab (225 mg) had the highest odds of ≥ 50% reduction in migraine days (OR = 3.1684, p < 0.0001). erenumab (28 mg) showed the best safety profile (OR = 0.6815, p = 0.2220). fremanezumab ranked highest in both efficacy (SUCRA = 84.6%) and safety (SUCRA = 61.8%).

conclusionfremanezumab offers the best balance of efficacy and safety. Further long-term studies are needed.

Indexed as

Antibodies, MonoclonalCalcitonin Gene-Related PeptideMigraine DisordersAntibodies, Monoclonal, HumanizedHumansNetwork Meta-Analysis as TopicRandomized Controlled Trials as TopicAntibodies, MonoclonalAntibodies, Monoclonal, HumanizedCalcitonin Gene-Related PeptideerenumabfremanezumabgalcanezumabCGRP monoclonal antibodiesErenumabFremanezumabGalcanezumabMigraineMigraine preventionSafety and efficacyNetwork meta-analysis

Identifiers

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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.