PURPOSE OF REVIEW: The results of phase 2 randomized controlled trials for the 
prevention of episodic and chronic migraine demonstrating the efficacy and 
safety of four mAbs targeting the calcitonin gene-related peptide (CGRP) pathway 
[ALD403 (eptinezumab), AMG334 (erenumab), LY2951742 (galcanezumab) and TEV48125 
(fremanezumab)] have been published recently, and phase 3 trials are in process. 
This development will change headache management fundamentally. We aim to 
summarize and compare the phase 2 data.
RECENT FINDINGS: The change from baseline in the number of migraine days at the 
end of treatment in high-frequency episodic migraine was -1 (at weeks 5-8), -1.1 
(at weeks 9-12), -1.2 (at weeks 9-12) and -2.6 (at weeks 9-12) days for ALD403, 
AMG344, LY2951742 and TEV48125 (225 mg), respectively. Number needed to treats 
for responders and odds ratio for any adverse event were 4.7, 6.2, 4.0 and 4.0 
and 1.09, 0.96, 1.07 and 1.05, respectively.
SUMMARY: All four CGRP antibodies display comparable efficacy that does not 
differ significantly from that of the currently available oral antimigraine 
drugs. However, their safety and tolerability profiles as well as low frequency 
of administration looks promising but remains to be verified in long-term and 
large-scale trials. Considerations related to pregnancy, risk for cardiovascular 
effects and cost are subject for further evaluation.