Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Jun 19;272(7):468.
doi: 10.1007/s00415-025-13202-0.

Influence of triptans use on anti-CGRP mAbs response: a prospective, cohort study

Catello Vollono  1   2 , Marina Romozzi  3   4 , Antonio Munafò  5 , Giulia Vigani  5 , Francesco De Cesaris  5 , Paolo Calabresi  1   2 , Luigi Francesco Iannone  6   7
Affiliations

Influence of triptans use on anti-CGRP mAbs response: a prospective, cohort study

Catello Vollono et al. J Neurol. .

Abstract

Background: This study aimed to compare the differences in clinical characteristics and response to monoclonal antibodies against CGRP (anti-CGRP mAbs) between patients who habitually used triptans (TRIPTANS group) and patients who were non-current users (NO-TRIPTANS group).

Methods: In this prospective cohort study, all consecutive outpatients treated with anti-CGRP mAbs for 12 months were included. Clinical data were collected at baseline and monthly: number of headache days (MHDs), the absolute number of analgesics (AMNs), and the number of days with at least one analgesic (AMDs), Headache Impact Test-6 (HIT-6), and Migraine Disability Assessment (MIDAS) questionnaires. The outcomes were to evaluate the differences between TRIPTANS and NO-TRIPTANS groups (users or non-users of triptans in the 6 months before and during anti-CGRP mAb treatment) in MHDs and the other clinical variables during treatment. Response rates were assessed based on reductions in MHDs (≤ 25%, ≥ 50%, ≥ 75%).

Results: A total of 336 patients treated with mAbs were included. At baseline, NO-TRIPTANS group had higher MHDs (24.7 ± 6.7) compared to the TRIPTANS group (21.8 ± 6.9), p < 0.001. Comparative and normalized analyses showed significant and sustained lower MHDs in the TRIPTANS group during treatment. The MIDAS score was also significantly lower in the TRIPTANS group at month-3, 6, 9, 12, and lower AMDs and AMNs compared to NO-TRIPTANS group were seen in most of the time-points. The number of patients with ≥ 50% reduction of MHDs was significantly higher in the TRIPTANS group at months 1 and 12.

Conclusions: This study showed greater effectiveness of anti-CGRP mAb in habitual triptans users, possibly due to a common and/or synergistic action.

Keywords: CGRP; Migraine; Monoclonal antibodies; Predictor of response; Response.

PubMed Disclaimer

Conflict of interest statement

Declarations. Conflicts of interest: C.V. received personal fees from Eli Lilly, Abbvie, and Lundbeck. F.D.C. received personal fees from TEVA, Eli Lilly, Novartis, and Abbvie. L.F.I received financial support, honoraria for scientific lectures and presentations, consulting fees for the participation in advisory boards, and support for attending meetings from: Teva, Eli Lilly, Lundbeck, Pfizer, Organon, and AbbVie; he is Associate Editor for Frontiers in Neurology Headache and Neurogenic Pain section and Review Editor for Therapeutic Advances in Neurological Disorder. Other authors have no conflicting interests. Ethical approval: The study was approved as a part of the Registro Italiano Cefalee (RICe) study by the local Ethics committee (CEAVC Studio RICe, 14591_oss and subsequent amendments 2022-609; 2023).

Similar articles

See all similar articles

References

    1. Al-Hassany L, Goadsby PJ, Danser AHJ, MaassenVanDenBrink A (2022) Calcitonin gene-related peptide-targeting drugs for migraine: how pharmacology might inform treatment decisions. Lancet Neurol 21(3):284–294. https://doi.org/10.1016/s1474-4422(21)00409-9 - DOI - PubMed
    1. Vandervorst F, Van Deun L, Van Dycke A, Paemeleire K, Reuter U, Schoenen J, Versijpt J (2021) CGRP monoclonal antibodies in migraine: an efficacy and tolerability comparison with standard prophylactic drugs. J Headache Pain 22(1):128. https://doi.org/10.1186/s10194-021-01335-2 - DOI - PubMed - PMC
    1. Sacco S, Amin FM, Ashina M, Bendtsen L, Deligianni CI, Gil-Gouveia R, Katsarava Z, MaassenVanDenBrink A, Martelletti P, Mitsikostas D-D, Ornello R, Reuter U, Sanchez-del-Rio M, Sinclair AJ, Terwindt G, Uluduz D, Versijpt J, Lampl C (2022) European Headache Federation guideline on the use of monoclonal antibodies targeting the calcitonin gene related peptide pathway for migraine prevention—2022 update. J Headache Pain 23(1):67. https://doi.org/10.1186/s10194-022-01431-x - DOI - PubMed - PMC
    1. Charles AC, Digre KB, Goadsby PJ, Robbins MS, Hershey A (2024) Calcitonin gene-related peptide-targeting therapies are a first-line option for the prevention of migraine: an American Headache Society position statement update. Headache. https://doi.org/10.1111/head.14692 - DOI - PubMed
    1. Raffaelli B, Fitzek M, Overeem LH, Storch E, Terhart M, Reuter U (2023) Clinical evaluation of super-responders vs. non-responders to CGRP(-receptor) monoclonal antibodies: a real-world experience. J Headache Pain 24(1):16. https://doi.org/10.1186/s10194-023-01552-x - DOI - PubMed - PMC

LinkOut - more resources