Researchers have suggested that a certain type of migraine-prevention medication may be associated with a reduced risk of glaucoma, according to their study published in Neurology, the journal of the American Academy of Neurology.
The study compared 36 822 people who took calcitonin gene-related peptide (CGRP) inhibitor drugs to prevent migraine with the same number of people who took other types of migraine prevention drugs. I
It does not prove that CRGP inhibitor drugs directly cause the reduced risk of glaucoma, they said: it only shows 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 Rhode Island, USA.
“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 healthcare database for people newly prescribed drugs to prevent migraine and who 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-CRGP inhibitor group were valproate, topiramate, flunarizine, candesartan, lisinopril, metoprolol, propranolol, nadolol, amitriptyline and venlafaxine.
During the study, 153 people, or 0.42%, in the CGRP inhibitor group developed glaucoma, compared with 223 people, or 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 analysing 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.
The study was supported by Taichung Veterans General Hospital in Taiwan.
Study details
Glaucoma risk associated with calcitonin gene–related peptide inhibitor use in migraine a multinational cohort study
Chien-Chih Chou, Jr-Wei Wu, Hui-Ju Lin, I-Jong Wang, Ssu-Yu Pan and Chien-Hsiang Weng.
Published in Neurology on 6 May 2026
Abstract
Background and Objectives
Migraine has been linked to an increased risk of glaucoma, and our study aims to assess the temporal association between calcitonin gene–related peptide inhibitors (CGRPi) and the risks of glaucoma in individuals with migraine.
Methods
This multinational retrospective cohort study included adults diagnosed with migraine who received migraine preventive medications in 2018–2024. Participants were categorised into the CGRPi group (erenumab, fremanezumab, galcanezumab, eptinezumab, atogepant, or rimegepant) and non-CGRPi group (valproate, topiramate, flunarizine, candesartan, lisinopril, metoprolol, propranolol, nadolol, amitriptyline, and venlafaxine). Crossovers were not allowed, and the non-CGRPi group included only individuals who never used CGRPi. The CGRPi and non-CGRPi groups were propensity score matched in a 1:1 ratio and were followed for up to three years to monitor the occurrence of incident glaucoma. The Cox proportional hazards model was used to compare the risk of glaucoma between CGRPi and non-CGRPi users, with results reported as hazard ratios (HRs) and 95% CIs.
Results
A total of 73 644 individuals were included in the final analysis. Compared with non-CGRPi users, CGRPi users experience a lower risk of glaucoma development (HR 0.75; 95% CI 0.61–0.92) within three years since its first prescription. Individuals using CGRPi also exhibit a reduced risk of glaucoma compared with those using topiramate (HR 0.73; 95% CI 0.59–0.90), valproate (HR 0.54; 95% CI 0.35–0.83), propranolol (HR 0.76; 95% CI 0.59–0.98), metoprolol (HR 0.76; 95% CI 0.59–0.98), lisinopril (HR 0.49; 95% CI 0.38–0.62), amitriptyline (HR 0.69; 95% CI 0.54–0.89), and venlafaxine (HR 0.68; 95% CI 0.50–0.91). In the analysis that further classified participants based on the specific CGRPi used, only users of monoclonal antibody CGRPi show a reduced risk of glaucoma compared with non-CGRPi users (HR 0.77; 95% CI 0.61–0.98). The reduced risk of glaucoma associated with CGRPi is also observed in older adults, women, and those with chronic migraine or migraine without aura.
Discussion
Among adults with migraine receiving preventive treatment, systemic use of CGRPi, particularly monoclonal antibody CGRPi, is associated with a reduced risk of glaucoma compared with the use of other migraine preventive medications.
Neurology article –Certain Migraine Prevention Drugs Associated with Reduced Risk of Glaucoma
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