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EAN 2023 | Navigating migraine treatment choices: monoclonal antibodies vs gepants

Alan Rapoport, MD, University of California, Los Angeles, CA, delves into the extensive range of migraine treatment options. Choosing between monoclonal antibodies and gepants for a patient presents a challenging decision, as their mechanisms of action are similar: both target calcitonin gene-related peptide or the receptor. Therefore, the most effective therapeutic approach involves an exploration of various treatments and delivery methods, coupled with regular outcome assessments and treatment reevaluations. Notably, this strategy differs somewhat for women of childbearing potential, as it requires consideration of drug half-lives and potential side effects before prescribing; in this context, gepants hold an advantage. This interview took place at the European Academy of Neurology (EAN) 2023 Congress in Budapest, Hungary.

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Alan Rapoport reports the following disclosures: I have worked with all four of the monoclonal antibodies companies and both of the gepant companies.