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Anti-CGRP monoclonal antibodies are a class of biologic drugs designed for the preventive treatment of migraine and cluster headache. This therapeutic class targets the calcitonin gene-related peptide (CGRP) pathway, which plays a critical role in vasodilation and pain signaling along the trigeminal nerve pathways. The class includes four FDA-approved agents: erenumab (which targets the CGRP receptor), and fremanezumab, galcanezumab, and eptinezumab (which directly target the CGRP ligand). These large-molecule biologics are typically administered via subcutaneous injection or intravenous infusion. In clinical trials and academic studies, such as those conducted by the Leiden University Medical Center (LUMC), they are evaluated for their ability to alter trigeminovascular activation and reduce the frequency of migraine and cluster headache attacks.
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