Clinical improvement of photophobia with galcanezumab in episodic and chronic migraine.

Objective: This study aimed to evaluate changes in photophobia using the Turkish version of Utah Photophobia Symptom Impact Scale-12 (UPSIS-12) in patients with episodic (EM) and chronic migraine (CM) treated with galcanezumab, and to examine the relationship between photophobia, migraine outcomes, disability, and treatment response. Background: Photophobia is one of the most bothersome symptoms (MBS) of migraine and may persist during both ictal and interictal periods, leading to substantial impairment in daily functioning. Despite the clear clinical relevance of photophobia, the specific effects of galcanezumab, a CGRP monoclonal antibody, on photophobia have not yet been fully elucidated. Methods: This retrospective study, included patients with EM and CM treated with galcanezumab (240 mg loading dose followed by monthly 120 mg) for 3 months. Patients completed headache diaries and validated patient-reported outcome measures (PROMs) at baseline and monthly follow-up visits. Non-parametric tests, correlation analyses, and multivariable linear regression were performed. Results: A total of 77 patients were enrolled, of whom 47 (89.3% female; mean age 39.5 ± 10.6 years) completed all study visits and were included in the final analysis. Over the study period, monthly headache days (MHDs) decreased from a median of 15 to 4 days by month 3 ( Conclusion: Galcanezumab was associated with clinically important reduction not only in migraine frequency, severity, disability, and psychological comorbidities, but also in ictal photophobia, highlighting its responsiveness to CGRP-targeted preventive therapy. These findings suggest that photophobia as a potentially modifiable outcome that warrants systematically evaluation in future studies, with larger cohorts and long-term follow-up.