New Migraine Drug Linked to 40% Higher Miscarriage Risk!

Researchers have uncovered a link between a new generation of migraine medications and a 40% increase in the risk of miscarriage.

According to Ambassador Arjan, migraine is a very common neurological disease, the prevalence of which is even higher in women.

Treating migraine attacks is difficult and challenging; Because common pain relievers such as non-steroidal anti-inflammatory drugs (NSAIDs) and acetaminophen often do not work.

In 2018, a new generation of injectable drugs was approved for the treatment of migraine. These drugs are an option for patients who do not respond to conventional oral treatments, such as triptans or ergotamine.

However, a new study published in JAMA Neurology shows that this treatment can increase the risk of miscarriage in pregnant women.

These drugs, called CGRP-targeting monoclonal antibodies (mAbs), work by blocking CGRP (calcitonin gene-related peptide) molecules. These drugs usually have fewer side effects and drug interactions compared to other migraine drugs.

CGRP molecules play an essential role in the occurrence of migraine attacks, but are also involved in the regulation of blood flow, fetal implantation, and placental development during pregnancy.

The new study, led by Anick Bérard, an epidemiologist at Sainte-Justine University Hospital in Canada, suggests that CGRP-blocking monoclonal antibodies may interfere with pregnancy. However, the available evidence at this stage is still very limited.

This study is observational; This means that it can only show the existence of a relationship (correlation) and is not able to prove a cause and effect relationship.

Researchers analyzed the first 20 weeks of pregnancy of 7,579 mothers using the available data set collected by private health insurance companies between 2018 and 2021. The selection criteria of these mothers based on their medical records included an official diagnosis of migraine or the prescription of triptan or ergotamine drugs in the period of 6 months before the last menstrual period.

Some of these mothers were prescribed anti-CGRP monoclonal antibodies (including erenumab, frimanzumab, galcanzumab, or aptinzumab) or propranolol during pregnancy or 6 months before.

The researchers analyzed the data based on the number of days of exposure to these two categories of drugs ("person-time" criteria).

Berard and his research team report that exposure to anti-CGRP monoclonal antibodies was associated with an increased risk of spontaneous abortion (compared to periods without exposure), whereas exposure to propranolol was not.

In the first 20 weeks of pregnancy, the probability of miscarriage in mothers who were treated with anti-CGRP monoclonal antibodies was about 40% higher than in mothers who were not exposed to this drug. This is despite the fact that the use of propranolol was not associated with any increased risk.

Although these results are alarming, if you have migraines and are planning to become pregnant, you should consult your doctor about the treatment process and potential risks before making any changes to your medication regimen.

It should be said that a study like this cannot prove that a particular drug is necessarily the cause of abortion.

Since these drugs are usually prescribed for severe and refractory cases of migraine, it is possible that the migraine itself may contribute to the increased risk of miscarriage.

These data have other limitations. The records used are from the population in the United States covered by commercial insurance. Therefore, the results may not apply to the uninsured, those covered by government insurance, or residents of other countries.

Also, insurance records are not necessarily collected for the purpose of conducting detailed medical research. For example, the data in this study did not take into account factors such as migraine severity in each individual, actual use of prescribed medications, or planned pregnancy.

The researchers emphasize that this study highlights the need for further research on the safety of anti-CGRP monoclonal antibodies during pregnancy.

They say: Considering the increasing use of anti-CGRP monoclonal antibodies for the prevention of migraine in people of reproductive age, it is necessary to conduct more research to evaluate the safety of these drugs during pregnancy. Research that examines issues such as spontaneous abortion, fetal outcomes, and long-term outcomes for children.

Until more evidence becomes available, clinicians should consider the limited evidence available on the safety of these drugs in pregnancy when discussing treatment with anti-CGRP monoclonal antibodies with people who may become pregnant, they added.