Conference Coverage

GLP-1 Receptor Agonists Associated With Lower Healthcare Utilization in Chronic Migraine

Edited by:
Anthony Calabro, MA

Key Highlights

  • GLP-1RA initiation was associated with lower rates of emergency department visits and hospitalizations versus topiramate.
  • Patients receiving GLP-1RAs had reduced triptan use and fewer nerve block procedures.
  • Initiation of additional preventive therapies, including CGRP monoclonal antibodies and valproate, was less frequent with GLP-1RAs.
  • No significant difference was observed in beta-blocker initiation between groups.

Investigators reported that initiation of GLP-1 receptor agonists (GLP-1RAs) was associated with reduced healthcare utilization and less escalation to additional preventive therapies compared with topiramate, a medication that treats epilepsy, as well as prevent migraines, in adults with chronic migraine. These findings were presented at the 2026 American Academy of Neurology Annual Meeting in Chicago, IL.

The study addresses a gap in evidence regarding the potential role of GLP-1RAs—agents commonly used for metabolic disorders—in migraine management, given their proposed anti-inflammatory and neurovascular effects.

Using a real-world, active-comparator cohort design, researchers analyzed data from the TriNetX database. Adults diagnosed with chronic migraine who initiated a GLP-1RA within 12 months of diagnosis were compared with those initiating topiramate. GLP-1RA agents included liraglutide, semaglutide, dulaglutide, exenatide, lixisenatide, and albiglutide.

Cohorts were matched 1:1 using propensity scores based on demographics, body mass index, comorbidities, and prior use of preventive therapies, including beta-blockers, tricyclic antidepressants (TCAs), serotonin-norepinephrine reuptake inhibitors (SNRIs), valproate, CGRP monoclonal antibodies or gepants, and onabotulinumtoxinA. Outcomes assessed over 12 months included emergency department visits, hospitalizations, nerve block procedures, triptan prescriptions, and initiation of new preventive treatments. Risk ratios (RRs) with 95% confidence intervals were calculated.

Study Findings

After matching, 10,997 patients were included in each cohort, with a mean age of 48 years and 87.8% female representation. Baseline characteristics were well balanced between groups.

Compared with topiramate initiators, patients receiving GLP-1RAs demonstrated lower risk of emergency department visits (RR, 0.90; 95% CI, 0.86–0.94), hospitalizations (RR, 0.86; 95% CI, 0.81–0.91), and nerve block procedures (RR, 0.87; 95% CI, 0.78–0.97). Triptan use was also reduced (RR, 0.87; 95% CI, 0.84–0.91).

GLP-1RA initiation was further associated with lower likelihood of starting additional preventive therapies, including TCAs (RR, 0.65; 95% CI, 0.55–0.77), valproate (RR, 0.52; 95% CI, 0.40–0.68), gepants (RR, 0.77; 95% CI, 0.69–0.85), CGRP monoclonal antibodies (RR, 0.58; 95% CI, 0.52–0.65), and SNRIs (RR, 0.80; 95% CI, 0.64–0.995). No significant differences were observed for beta-blocker initiation.

Clinical Implications

According to the study authors, these findings suggest that GLP-1RA initiation in patients with chronic migraine may be associated with reduced acute-care utilization and decreased need for escalation to additional preventive therapies compared with topiramate. The authors emphasize that these observations support further investigation of GLP-1RAs as a potential option in migraine management.

Expert Commentary

“In chronic migraine, GLP-1RA initiation compared with topiramate was associated with lower acute-care utilization and less escalation to additional preventives, despite similar baseline profiles. These findings suggest a potential role of GLP-1RAs in migraine management and warrant prospective evaluation,” the researchers concluded.

Reference
Acar V, Franco M, Wang V, Yuan H. GLP-1 receptor agonists and chronic migraine: A real-world cohort study of healthcare utilization and preventive escalation. Presented at: 2026 American Academy of Neurology Annual Meeting; April 18-22, 2026; Chicago, IL. Abstract P10.017. https://index.mirasmart.com/AAN2026/SearchResults.php?q=chronic+migraine&pg=