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CGRP for Migraine: Setting the Right Expectations

CGRP for Migraine: Setting the Right Expectations

During the 60th Annual American Headache Society (AHS) Scientific Conference in San Francisco, I had the distinct pleasure of sitting down with Dr. David Dodick, professor of neurology and a headache specialist at the Mayo Clinic in Phoenix, Arizona. Dr. Dodick is the Medical Director of the Headache Program as well as the Concussion Program. He is a past president of AHS and of the International Headache Society. Dr. Dodick has authored more than 280 peer-reviewed publications and coauthored 8 books.

Dr. Dodick has been highly involved in the research and clinical trials of Calcitonin Gene-Related Peptide (CGRP) inhibitors, the first class of medications developed specifically made for the prevention of migraine.

CGRPs – are they really game changers?

With much fan fare surrounding CGRP inhibitors, I felt that it was important to ask Dr. Dodick about setting expectations. While trial results have been very promising, this will not work for everyone. There is still no cure for migraine. In this video, he shares the discussion that he has with his own patients.

CGRP clinical trial results

“The way we define clinical response is going to be different than in clinical trials and it’s going to be the patient who defines whether or not he or she is responding.”

A patient trying the first CGRP inhibitor has a 1 in 5 chance of not responding at all, but “the good news is that there is more coming.”

Optimistic about the future of migraine treatments

Dr. Dodick admits that he also has to set his own expectations of how his patients are going to respond. Truly an optimist, he’s disappointed that a patient doesn’t have more relief based on the clinical trial criteria, but to a patient who experiences a decrease in the average severity of their migraine can be truly life changing. “I have to adjust my expectations because patients are grateful for anything you can do for them.”

“I’m excited. I’ve never been more excited.” Dr. Dodick concludes that the future has never looked brighter.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.


  • Kim DH
    6 months ago

    As a migraineur, expectations are high, but so is the fear that, as has happened so many times before, it won’t work. It’s so exhausting to get your hopes up with each new treatment you try, only to have them dashed when they either don’t work at all, or quit working after only a short time.

  • hobbitgirl
    5 months ago

    I think most of us can relate to the fear/hope duality of trying new things.

    I have to have hope, because without it, life would not be worth living (now that family grown and gone)

    Every time I reached the end of my rope, I reached out, found something new to try, learned from it, very slowly improved…

    As time has gone on (31.5 yrs), I have identified more triggers (over 50), and more things that help. So while I still get them many times a month, they aren’t as bad as first 18 years or so….

    I do clinical trials because even if the treatment doesn’t help me, it furthers the science, which give my suffering purpose.

    I have also become a student of Buddhism, which is not a religion (you can keep your God!), but a psychology and way of life. When my migraines are bad, Buddhism helps me cope, find some sense in it.

    Which means, Hope “works” for me. Don’t give up….

  • mengucci
    10 months ago

    I have participated in a CGRP study at Jefferson Headache Center, in Philadelphia under Dr. Silberstein for the past 5 years. The past 4 years I have received the drug. It has been life changing for me. I was getting, at the least, 1 migraine/week. I now get less than 1 migraine/month. My quality of life before the study was nil. I now have my life back. This medication is truly groundbreaking and I hope they can develop a different form that more migraine sufferers will respond to it. For all migraine sufferers, it’s worth a try.

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