Headache research in 2022: advances and remaining challenges

Drugs targeting the calcitonin gene-related peptide (CGRP) pathway have transformed the management of migraine. Several publications have shown the efficacy of monoclonal antibodies to CGRP or its receptor for prophylaxis of difficult-to-treat migraine. In 2022, this work was complemented by a study of intravenous eptinezumab in patients with 2–4 previous unsuccessful attempts at prophylactic treatment.1 In line with data from studies with erenumab, galcanezumab, and fremanezumab, a single infusion of 100 mg or 300 mg eptinezumab led to a significant reduction in monthly migraine days compared with the placebo group during the 12-week double-blind observation period (difference from placebo –2·7 days [95% CI –3·4 to –2·0] with 100 mg eptinezumab and –3·2 days [–3·9 to –2·5] with 300 mg eptinezumab).