We performed a systematic review and meta-analysis to evaluate the effect of erenumab on systemic blood pressure (BP) in patients with migraine.

The US Prescribing Information for erenumab was updated to include the potential risk of hypertension, although randomized trials did not link it previously. The association of this monoclonal antibody with an elevated BP remains uncertain.

Embase, PubMed, and the Cochrane were searched up to June 18 for studies examining the impact of erenumab on BP in migraineurs. I2 statistics and prediction intervals (PI) assessed heterogeneity, and sensitivity and subgroup analysis were used to explore it. Data was collected using mean difference (MD) or proportion of events. The quality of the studies was assessed with the Cochrane Risk of Bias tool. Generative AI was used only to enhance scientific writing clarity, with authors critically evaluating accuracy after each intervention.

We did not find an association of erenumab with an increased BP. However, there is considerable uncertainty in the current evidence. The decision to prescribe erenumab, especially for patients with multiple comorbidities, must be made weighing up risks and benefits. Further studies are needed to confirm the findings.