In this systematic review and meta-analysis, we aimed to assess the efficacy and safety of galcanezumab doses in chronic and episodic migraines.

Migraine is a severe kind of headache and is represented by 14% of the population and up to 18% of women. Galcanezumab is a humanized monoclonal antibody that binds to calcitonin gene-related peptides and is used to prevent migraines. 

In September 2022, we conducted a comprehensive search in five databases, including EMBASE, PubMed, Cochrane Library, Web of Science, and SCOPUS. We appraised each study using the Cochrane risk of bias tool. Our primary outcome was the change in the monthly migraine headache days (MMDs). Data were extracted and analyzed using RevMan version 5.4.

We included eight randomized controlled trials with 3651 migraine patients. In episodic migraine, galcanezumab (120-150 and 240-300mg) showed a significant reduction in MMDs compared to placebo after six months. Also, in chronic migraine, galcanezumab (120mg) reduced MMDs compared to placebo after three months. The analysis was conducted according to each month's records, and the mean difference change ranged from -1.62 to -2.86 (P-value < 0.001). All doses showed a significantly higher rate in ≥50%, ≥75%, and 100% response rates. Regarding safety outcomes, galcanezumab was associated with injection site-related complications such as pruritis, reaction, swelling, or erythema. In contrast, the two groups showed no difference regarding any adverse or serious adverse events, upper respiratory tract infection, oropharyngeal pain, injection site pain, back pain, sinusitis, and diarrhea.

Subcutaneous galcanezumab reduced MMDs and increased response rates in chronic and episodic migraine patients. It is generally safe except for injection-related complications.