Calcitonin Gene–Related Peptide Inhibitors and Cardiovascular Events in Patients With Migraine

作者：Jay B. Lusk, Lauren E. Wilson, Carlene Moore, Stephanie Yarnell, Cheryl Kalapura, Aparna Choudhury, Matthew Schrag, Sven Poli, Li Fan, Brian Mac Grory · 发表于：Neurology · 年份：2026 · DOI：10.1212/wnl.0000000000214479 · 被引用次数：7 · 研究领域：Migraine and Headache Studies、Traumatic Brain Injury Research、Neurological Complications and Syndromes

BACKGROUND AND OBJECTIVES: Calcitonin gene-related peptide (CGRP) inhibitors have entered widespread use in the United States for treatment of migraine, but data on their cardiovascular risk profile are lacking. The objective of this study was to determine whether exposure to a CGRP inhibitor is associated with cardiovascular events in patients with migraine. METHODS: A retrospective, observational, cohort study was conducted using computerized claims data from a proprietary, insurance-based registry, MarketScan (by Merative). Beneficiaries with at least one claim related to a migraine diagnosis and continuous coverage for at least 12 months before migraine diagnosis were included. Using a sequential trial framework, the rate of cardiovascular events was computed in those who did and did not initiate a CGRP inhibitor, using both crude estimates and those derived in propensity score overlap-weighted cohorts. Adjusted hazard ratios (HR) and corresponding 95% CI were computed. The principal exposure was initiation of any CGRP inhibitor. The primary end point was a composite of myocardial infarction (MI), cerebral ischemic stroke, revascularization, peripheral arterial disease, or central retinal artery occlusion (CRAO). Secondary end points included each component individually. A falsification end point (humeral fracture) was included. RESULTS: In total, 900,370 beneficiaries (median age 41 [Q1, Q3: 31, 51] years; 77.8% female) were included, of whom 58,679 initiated a CGRP inhi...