Headline October 12 2026 JAMA NEUR0LOGY report-Early Pregnancy Use of Anti-CGRP Monoclonal Antibodies is associated with spontaneous abortion risk.
The CGRP group of drugs for migraine prevention have been important additions to migraine preventive therapy the last few years. My previous statement on CGRP Preventive was:
Goal of preventive treatment
The goal of CGRP migraine preventive treatment is to reduce the frequency, intensity, duration, and disability associated with migraine attacks. The American Headache Society (AHS) states that preventive therapy is indicated for approximately 40% of people with migraine.
The CGRP drugs
These are the monoclonal antibodies, Ajovy (fremanezumab), Emgality (galcanezumab), Aimovig (erenumab), and Vyepti (eptinezumab).
AHS previous review results
The AHS “found the evidence supporting the efficacy, tolerability, and safety of CGRP-targeting therapies…for migraine prevention to be substantial in its volume, scope, and quality.”
Recent JAMA Neurology October 12 2026 statement.
Question Is exposure to anti-calcitonin gene-related peptide (CGRP) monoclonal antibodies during early pregnancy associated with spontaneous abortion in individuals with migraine?
Findings In this cohort study of 7579 pregnancies, anti-CGRP monoclonal antibody exposure was associated with an increased risk of spontaneous abortion compared with unexposed person-time, while propranolol exposure was not.
Meaning These results demonstrate that early pregnancy exposure to anti-CGRP monoclonal antibodies may be associated with an increased risk of spontaneous abortion, supporting further evaluation of their safety during pregnancy and informing treatment decisions for individuals of childbearing potential.
Britt Talley Daniel MD assesment. Doctors prescribing CGRP drugs for migraine have not previously known these facts and patients have not been adequately medically advised of the possible risk factor of a miscarriage from taking CGRP drugs. Due to their long half life CGRP should be stopped 5 months before pregnancy.
Further development of this situation, such as a follow up statement from the Americn Headache Society are likely fore coming.
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Britt Talley Daniel MD