CGRP mAbs + onabotulinumtoxin A

CGRP mAbs + onabotulinumtoxin A is a combination therapy regimen currently being evaluated in the Phase III NorMig (Nordic Chronic Migraine Trial) for the prevention of chronic migraine. This dual-modality approach combines Calcitonin Gene-Related Peptide (CGRP) monoclonal antibodies—which include erenumab, fremanezumab, galcanezumab, or eptinezumab—with onabotulinumtoxinA (Botox). OnabotulinumtoxinA is a biologic neurotoxin that inhibits the release of nociceptive neurotransmitters and neuropeptides from peripheral sensory nerve endings by cleaving SNAP-25. CGRP mAbs work by either binding to the CGRP ligand or its receptor, thereby blocking the pro-inflammatory and vasodilatory effects of CGRP in the trigeminovascular system. The trial, led by Oslo University Hospital, aims to determine if this combination provides superior reduction in monthly migraine days compared to CGRP mAb monotherapy in patients who continue to experience significant disability despite single-agent preventive treatment.

Other names

CGRP monoclonal antibodies + onabotulinumtoxinACGRP mAbs and onabotulinumtoxin ABotox + CGRP mAbsNorMig regimen