• A recent study indicates that CGRP monoclonal antibodies are not more clinically effective than topiramate or Botox for treating chronic migraine, challenging their preferential use.
• The analysis of multiple randomized controlled trials revealed that CGRP monoclonal antibodies reduce headache days by 2.0 to 2.5 days per month, comparable to other treatments.
• Economic modeling suggests topiramate is the most cost-effective option for chronic migraine if patients are willing to pay a certain threshold per quality-adjusted life-year.
• Future research should focus on comparing CGRP monoclonal antibodies with Botox alone, as well as candesartan and flunarizine against placebo, to optimize treatment strategies.