Migraine

Migraine prevention and acute treatment have been transformed by CGRP-targeted therapies with multiple agents now established. The session covers gepants for prevention (atogepant, rimegepant) and acute treatment (ubrogepant, rimegepant), monoclonal antibodies (erenumab, fremanezumab, galcanezumab, eptinezumab) and head-to-head data, zavegepant nasal as the first non-oral non-injectable acute treatment, ditans (lasmiditan), and emerging therapies for refractory migraine. Discussion addresses hormonal migraine and pregnancy considerations, vestibular migraine, pediatric migraine and FDA-approved options, the comparison of CGRP MAbs head-to-head, real-world adherence data, neuromodulation devices (Cefaly, gammaCore), and the equity considerations in expensive biologic migraine therapy.