Evidence map›Paper›PMID 41808003›Full record

Trial reportThe journal of headache and pain2026

Anti-CGRP receptor antibodies do not modulate trigeminal pain processing: indication for distinct mechanisms of CGRP pathway blockade.

Kuan-Po Peng, Hauke Basedau, Karl Messlinger, Arne May

Abstract readRandomized Controlled Trial
In one paragraph

Trial report in The journal of headache and pain, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Kuan-Po PengDepartment of Systems Neuroscience, University Medical Center Hamburg- Eppendorf, Martinistraße 52, 20246, Hamburg, Germany.
Hauke BasedauDepartment of Systems Neuroscience, University Medical Center Hamburg- Eppendorf, Martinistraße 52, 20246, Hamburg, Germany.
Karl MesslingerInstitute of Physiology and Pathophysiology, Friedrich-Alexander- Universität Erlangen-Nürnberg, Universitätsstr. 17, 91054, Erlangen, Germany.
Arne MayDepartment of Systems Neuroscience, University Medical Center Hamburg- Eppendorf, Martinistraße 52, 20246, Hamburg, Germany. a.may@uke.de.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMonoclonal antibodies (mAbs) targeting calcitonin gene-related peptides (CGRP) are established therapies for migraine. There are currently four CGRP-mAbs available on the market: one targets the CGRP receptor, and the other three target the CGRP ligand. Despite the initial comparability of the two groups regarding efficacy, real-life data demonstrate that up to 30% of non-responders to one class exhibit a positive response to switching classes, indicating different mechanisms. The ligand-mAb, galcanezumab, has previously demonstrated a trigeminal dermatome-specific pain modulatory effect. The present study aims to evaluate the sensory modulatory effect of the receptor-mAb, erenumab.

methodsMigraine patients were recruited in two phases. In the first phase of the study, 40 patients were included and randomly assigned to receive either erenumab 70 mg (21 patients) or a placebo (19 patients) in a double-blind manner. In the second phase of the study, 46 patients were included and received erenumab 140 mg in an open-label manner. Quantitative sensory testing (QST) parameters were measured on the right forehead (V1 dermatome) and on the forearm prior to and after treatment. A repeated-measures analysis of variance (ANOVA) was used for the statistical analysis.

resultsAll three study cohorts (placebo, erenumab 70 mg, and erenumab 140 mg) were comparable in terms of demographics, including age, sex ratio, and baseline headache frequency, and showed no statistically significant differences in QST parameters. Subsequent to the administration of the treatment, no changes or discernible trends were observed in any of the QST parameters in any study cohort.

conclusionsThe findings of this study suggest that the receptor-mAb, erenumab, did not modify the sensory thresholds following treatment. This finding is in contrast with the results of galcanezumab in the literature, which demonstrated a trigeminal sensory modulatory effect after treatment. This outcome indicates a different mechanism of action between the anti-CGRP receptor versus ligand mAbs and provides a scientific basis for the rationale of class switching, which aims to achieve additional clinical benefits in patients who are non-responders to anti-CGRP treatment. PREREGISTRATION: The study was preregistered at the Open Science Framework ( https://osf.io/ygf3t ).

Indexed as

Antibodies, Monoclonal, HumanizedCalcitonin Gene-Related PeptideCalcitonin Gene-Related Peptide Receptor AntagonistsMigraine DisordersReceptors, Calcitonin Gene-Related PeptideAdultDouble-Blind MethodFemaleHumansMaleMiddle AgedAntibodies, Monoclonal, HumanizedCalcitonin Gene-Related PeptideCalcitonin Gene-Related Peptide Receptor AntagonistserenumabReceptors, Calcitonin Gene-Related PeptideEfficacyModulationPreventiveQSTSensitivitySensitizationSwitchTrigeminal

Identifiers

PMID41808003
PMCPMC12973897

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.