Migraine management remains a clinical challenge, with many patients experiencing insufficient control despite current preventive therapies. While anti-CGRP monoclonal antibodies demonstrate efficacy in reducing migraine days, a significant proportion of patients do not achieve optimal control. New data indicates that GLP-1 receptor agonist initiation does not improve migraine frequency, yet it is associated with a reduction in migraine-related healthcare utilisation.1,2,3
The International Headache Society has established treatment goals for migraine prevention, aiming for higher standards of care in real-world settings. These goals include migraine freedom (no monthly migraine days (MMD)), optimal control (< 4 MMD), modest control (4-6 MMD), and insufficient control (>6 MMD).1,2,3
Real-world efficacy of anti-CGRP monoclonal antibodies
A prospective, real-world, European multicentre study, the EUREkA cohort, assessed the proportion of individuals achieving these treatment goals after 6 months of migraine-specific treatment with anti-CGRP monoclonal antibodies (MAbs). The study included 5,818 adults with migraine, of whom 4,963 had 6 months of data. The cohort was predominantly female (82.3%, 4,086/4,963) with a median age of 48.0 years (interquartile range: 40.0-55.0).1,2,3
At baseline, participants had a high migraine burden, with a median monthly headache days (MHD) of 20.0 (13.3-28.0) and MMD of 15.0 (10.0-20.0). All participants were classified as having insufficient headache control (>6 MMD) at baseline.1,2,3
After 6 months of anti-CGRP MAb treatment, the distribution across treatment goal categories was as follows:1,2,3
- Migraine freedom: 6.9% (342/4,963)
- Optimal control: 22.9% (1,137/4,963)
- Modest control: 24.6% (1,223/4,963)
- Insufficient control: 45.6% (2,261/4,963)
Within the insufficient control group, 27.1% (613/2,261) achieved a ≥50% reduction in MMD. These findings indicate that high standards of care, defined as optimal disease control or migraine freedom, are achieved in approximately 30% of individuals with a high migraine burden in real-world settings with anti-CGRP MAbs.1,2,3
The study highlights the need to expand global access to these treatments and suggests that initiating migraine-specific preventive treatments earlier could potentially further reduce residual migraine days in responders, thereby enabling a larger proportion of patients to achieve optimal disease control.1,2,3
The EUREkA cohort data provides a clear benchmark for the real-world effectiveness of anti-CGRP monoclonal antibodies in migraine prevention. While a 30% rate of optimal control or migraine freedom is a significant achievement for patients with high migraine burden, it also underscores that nearly half of patients still experience insufficient control. This necessitates a continued focus on optimising existing migraine-specific therapies and exploring new avenues for the substantial proportion of patients who do not respond adequately.
The observation that GLP-1 receptor agonists do not improve migraine frequency, despite reducing healthcare utilisation, presents an interesting dichotomy. It suggests that any perceived benefit in healthcare resource use is likely indirect, perhaps related to improvements in comorbidities such as obesity or diabetes, rather than a direct antimigraine effect. Clinicians should be cautious not to conflate these indirect benefits with a primary migraine treatment effect. The evidence remains clear: for migraine improvement, specific migraine preventive treatments are paramount.
For the pharmaceutical industry, the EUREkA findings reinforce the market for anti-CGRP MAbs while also highlighting the unmet need for more effective treatments for non-responders. Investment in research for novel migraine-specific mechanisms, or strategies to enhance response rates to current therapies, remains critical. The data also implicitly cautions against overstating the migraine benefits of drugs primarily indicated for other conditions, even if they show ancillary reductions in healthcare visits.
- The Pivot GLP-1 receptor agonists, primarily used for diabetes and weight management, do not directly improve migraine frequency.
- The Data Approximately 30% of individuals with high migraine burden achieve optimal disease control or migraine freedom with anti-CGRP monoclonal antibodies.1,2,3
- The Action Clinicians should continue to prioritise migraine-specific preventive treatments for migraine improvement, while noting potential indirect benefits of GLP-1s on healthcare utilisation.
ART-2026-421
06/26
Cite This Article
Team TLSFE. Glp-1s do not improve migraines, but reduce healthcare utilisation. The Life Science Feed. Updated June 19, 2026. Accessed June 19, 2026. https://thelifesciencefeed.com/neurology/migraine-disorders/research/glp-1s-do-not-improve-migraines-but-reduce-healthcare-utilisation.
Editorial & AI Standards
All content is researched from peer-reviewed, open-access sources — published trial data, clinical guidelines, and regulatory filings. AI tools are used solely to structure and summarise that evidence; no AI-generated conclusions appear without editor verification against the primary source.
Every article is reviewed by a named editor before publication. Source citations are listed in the References section. This content does not represent the views of any pharmaceutical company, medical device manufacturer, or healthcare provider.
Licence & Rights
© 2026 The Life Science Feed. All rights reserved. Unless otherwise indicated, all content is the property of The Life Science Feed and may not be reproduced, distributed, or transmitted in any form or by any means without prior written permission.
Medical Disclaimer
The information provided on The Life Science Feed is for educational and informational purposes only. It is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider regarding any medical condition or treatment decision. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.
References
1. Caronna E, Mas-de-Les-Valls R, Egeo G. Is achieving higher standards in real-world migraine care feasible with anti-CGRP monoclonal antibodies preventive therapies?: Insights from the EUREkA cohort. Cephalalgia 2026.
2. Tabaac BJ, Carhart-Harris RL, Yung T. Clinical improvement following an integrative iboga microdosing protocol in post-concussive and hypoxic brain injury syndromes: a case series. Front Pharmacol 2026.
3. Goto F, Wasano K. Aripiprazole as second-line pharmacotherapy for a heterogeneous cohort of refractory functional dizziness disorders: a pilot preliminary retrospective study. Front Neurol 2026.
