HMN 2026: How Certain migraine prevention drugs are associated with reduced risk of glaucoma

A type of drug used to prevent migraine may be associated with a reduced risk of glaucoma, according to a study published in Neurology. The study compared 36,822 people who took calcitonin gene-related peptide (CGRP) inhibitor drugs to prevent migraine to the same number of people who took other types of migraine prevention drugs. However, the results do not prove that CGRP inhibitor drugs directly cause the reduced risk of glaucoma; they only show an association.

“Glaucoma is a leading cause of blindness, and evidence has linked migraine with an increased risk of glaucoma, with both conditions affecting the capacity of the blood vessels in the brain to alter blood flow in response to stimuli,” said study author Chien-Hsiang Weng, MD, MPH, of Brown University in Providence, Rhode Island. “Since CGRP inhibitors help regulate blood vessel contraction and inflammation in the nervous system, there has been hope that these drugs could benefit eye health in people at risk of glaucoma.”

For the study, researchers examined a health care database for people newly prescribed drugs to prevent migraine and had at least one refill. They were then followed for up to three years to see who developed glaucoma.

The drugs in the CGRP inhibitor group were erenumab, fremanezumab, galcanezumab, eptinezumab, atogepant and rimegepant. The drugs in the non-CGRP inhibitor group were valproate, topiramate, flunarizine, candesartan, lisinopril, metoprolol, propranolol, nadolol, amitriptyline and venlafaxine.

During the study, 153 people (0.42%) in the CGRP inhibitor group developed glaucoma, compared to 223 people (0.61%) of those in the non-CGRP inhibitor group.

After adjusting for other factors that could affect the risk of glaucoma, such as age, migraine frequency and history of high blood pressure, researchers found that those taking CGRP inhibitors had a 25% lower risk of developing glaucoma than those taking the other migraine drugs.

In further analyzing the results, researchers found that the reduced risk of glaucoma was only evident in CGRP inhibitors using monoclonal antibodies. These were erenumab, fremanezumab, galcanezumab and eptinezumab. The reduced risk was not found with CGRP receptor antagonists, or gepants. These were atogepant and rimegepant.

“Further studies are needed to confirm these results, but the findings may help us better understand both migraine and glaucoma,” Weng said.

A limitation of the study is that researchers were unable to assess family history of glaucoma or other information about glaucoma risk that could have influenced the results.

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