Calcitonin gene-related peptide antagonism for acute treatment of migraine: a meta-analysis

Purpose: Calcitonin gene-related peptide (CGRP) is an effector of acute migraine attack. And the CGRP antagonisms have shown some early promise in the treatment of migraine. Here, we performed a meta-analysis to evaluate the efficacy of CGRP antagonisms in treating acute migraine attack. Methods: Pubmed, Cochrane Library, Web of Science and OvidSP were systematically searched up to 9 April 2015 for randomized controlled trials (RCTs) which is dealing with the efficacy of CGRP antagonisms in treating acute migraine attack. The bias and quality of RCTs were assessed with Cochrane collaboration's tool for assessing risk of bias. Reviewer manager 5.2 was utilized for data analysis. Results: Totally 13 publications matched the inclusion criteria, including 10 independent RCTs and 6803 patients. Pooled analysis indicated that CGRP antagonisms had better outcomes in number of patients with pain free at 2h, 2-24h sustained pain free, phonophobia free at 2h, patients with photophobia free at 2h and nausea free at 2h post-dose, as compared with placebo. But CGRP antagonisms were no superior than 5-HT agonists in the indices above mentioned. Conclusions: CGRP antagonisms may be an effective and promising treatment for acute migraine attack.