[Joint practical guideline of the Hungarian Pain Society Chronic Headache Working Group and the Hungarian Headache Society on the use of calcitonin gene-related peptide (CGRP)-targeting therapies in migraine].

INTRODUCTION

Inhibition of the calcitonin gene-related peptide (CGRP) pathway offers a novel therapeutic option in the prevention of migraine attacks.

OBJECTIVE

The aim of this guideline is to provide practical recommendations for the safe, effective, and personalized use of CGRP inhibitors in episodic and chronic migraine within Hungarian clinical practice.

METHOD: The recommendations were developed based on international guidelines and current clinical trial evidence. The guideline takes into account drug efficacy, side-effect profiles, contraindications, as well as considerations for specific patient populations.

RESULTS AND RECOMMENDATIONS: CGRP antagonists - including monoclonal antibodies and gepants - may be applied even as first-line acute or preventive treatments owing to their efficacy and favorable safety profiles, particularly when the patient's clinical status, preferences, or comorbidities justify their use. Adverse events are mostly mild, and overall safety is favorable. Therapeutic decisions should be followed by a three-month evaluation period, and in the case of insufficient response, drug switching or combination therapy should be considered.

CONCLUSION

According to international evidence, a structured therapeutic algorithm and a patient-tailored approach may have a beneficial effect and are expected to contribute to improved quality of life in patients with migraine. Orv Hetil. 2025; 166(50): 1963-1974.