• Curr Pain Headache Rep · Aug 2022

    Review

    Cardiovascular Disease and Migraine: Are the New Treatments Safe?

    • Jennifer Robblee and Lauren K Harvey.
    • Lewis Headache Center, Department of Neurology, Barrow Neurological Institute | St Joseph Health Center, 350 W. Thomas Rd, AZ, 85013, Phoenix, USA. Neuropub@barrowneuro.org.
    • Curr Pain Headache Rep. 2022 Aug 1; 26 (8): 647-655.

    Purpose Of ReviewThe authors present data on cardiovascular safety for the new acute and preventive migraine treatments including ditans, gepants, and calcitonin gene-related peptide monoclonal antibodies (CGRP mAbs) alongside older medications like triptans and ergotamines.Recent FindingsThe authors conclude that there are no cardiovascular safety concerns for lasmiditan, and that it could be used in those with cardiovascular disease. In fact, the literature even suggests that triptans are safer in cardiovascular disease than their contraindications may suggest. At this time, there is insufficient evidence that gepants and CGRP mAbs should be contraindicated in those with cardiovascular disease including stroke or myocardial infarction, though erenumab has now been associated with hypertension. Vasodilation may be an important CGRP-mediated mechanism mid-ischemia especially in patients with small vessel disease; hence, CGRP antagonists should be use with caution in this context. Long-term data is still needed, and prescribers should ensure patients are aware of the limitations of our knowledge at this time, while still offering these effective and well-tolerated treatment options.© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

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