European Headache Federation guideline on the use of monoclonal antibodies targeting the calcitonin gene related peptide pathway for migraine prevention – 2022 update

Table 2 Summary of the evidence-based recommendations

Recommendation	Quality of evidence^a	Strength of the recommendation
In individuals with episodic migraine we recommend eptinezumab, erenumab, fremanezumab and galcanezumab as preventive treatment	Eptinezumab 100 mg and 300 mg (q): moderate ⨁⨁⨁○ Erenumab 70 mg (m) and 140 mg (m): high ⨁⨁⨁⨁ Fremanezumab 225 (m) and 675 (q): high ⨁⨁⨁⨁ Galcanezumab 120 mg (m) + 240 mg (ld): high ⨁⨁⨁⨁	Strong ↑↑
In individuals with chronic migraine we recommend eptinezumab, erenumab, fremanezumab and galcanezumab as preventive treatment	Eptinezumab 100 mg and 300 mg (q): high ⨁⨁⨁⨁ Erenumab 70 mg (m): high ⨁⨁⨁⨁ Erenumab 140 mg (m): moderate ⨁⨁⨁○ Fremanezumab 225 mg (m): moderate ⨁⨁⨁○ Fremanezumab 675 mg (q): high ⨁⨁⨁⨁ Galcanezumab 120 mg (m) + 240 mg (ld): high ⨁⨁⨁⨁	Strong ↑↑
In individuals with episodic or chronic migraine we recommend erenumab over topiramate as preventive treatment because of better tolerability	Low ⨁⨁○○	Strong ↑↑

(m) indicates monthly, (q) indicates quarterly, ld indicates loading dose
^aFor drugs with differences in the quality of evidence across the different outcomes we provided the overall rating according to the highest quality of evidence since the risk of bias was considered minor

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