CME Information: CGRP Migraine

CGRP Blockade: The Evolving Landscape of Migraine Therapy

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Upon completion of this activity, participants should be better able to:

  • Summarize the underlying mechanism of CGRP and its role in the development of migraine
  • Assess the relative safety and efficacy of CGRP monoclonal antibodies for the treatment of acute and chronic migraine
  • Address issues of nonadherence in patients with migraine

Activity Description

Migraine headache is a common, disabling neurological disorder affecting nearly 40 million individuals in the United States. Migraine is frequently encountered in the primary care setting and is the fourth leading cause of Emergency Department visits. Nearly 90% of migraine sufferers experience moderate-to-severe pain during an attack and 75% have reduced ability to function normally during a migraine. Despite its well-established morbidity, disability and burden of disease, migraine remains poorly understood, with a high number of patients underdiagnosed and untreated; only a small number take migraine prophylaxis. Although therapies are available to treat migraine, many are associated with adverse effects and suboptimal response when used prophylactically. Thus, clinicians face a number of challenges in managing migraine.

Importantly, the development of CGRP monoclonal antibodies offers promise in managing migraine headache. However, clinicians must be intimately familiar with these agents and how they can be best incorporated into daily clinical practice for patients with migraine headache. Clinician education on these promising therapies, as well as education on the recognition, diagnosis, overall disease management and strategies to address patient nonadherence, will greatly improve outcomes in patients with migraine headache.

Disclosure of Commercial Support

This activity is supported by educational grants from Alder BioPharmaceuticals, Inc., Allergan, and Teva Pharmaceuticals.


This program is intended for neurologists, headache specialists, pain specialists and primary care clinicians, including those specializing in internal medicine and family medicine, as well as physician assistants, nurse practitioners and other health care providers who manage patients with chronic migraines.


  • Migraine – definition, prevalence, risk factors, and characteristics
  • Unmet medical needs for patients with migraine
  • Underlying pathophysiology of migraine headache
  • Role of CGRP in migraine headache
  • Treatment options – traditional systemic prophylaxis; CGRP monoclonal antibodies
  • Management of treatment-resistant/refractory migraine
  • Strategies to address non-adherence in chronic migraine

    There are no fees to participate in this activity. To participate in the activity, go to or To receive credit, participants must (1) read the target audience, learning objectives, and disclosure statements, (2) complete the educational activity online, and (3) complete the post-test and activity evaluation. To receive AMA PRA Category 1 Credits™, participants must receive a minimum score of 70% on the post-test.


    Live Activity
    March 29, 2019 from 12:00pm – 1:00pm ET.

    Enduring Material
    Release Date: March 29, 2019

    Expiration Date: March 29, 2020
    Time to Complete Activity: 1 hour

    Faculty & Disclosure / Conflict of Interest Policy

    It is the policy of Icahn School of Medicine at Mount Sinai to ensure objectivity, balance, independence, transparency, and scientific rigor in all CME–sponsored educational activities. All faculty participating in the planning or implementation of a sponsored activity are expected to disclose to the audience any relevant financial relationships and to assist in resolving any conflict of interest that may arise from the relationship. Presenters must also make a meaningful disclosure to the audience of their discussions of unlabeled or unapproved drugs or devices. The information will be available as part of the course material.

    Course Director:
    Mark W. Green, MD, FAAN
    Director of Headache and Pain Medicine
    Professor of Neurology, Anesthesiology, and Rehabilitation Medicine
    Icahn School of Medicine at Mount Sinai

    Sarah Vollbracht, MD
    Clinical Director, Montefiore Headache Center
    Program Director, Headache Fellowship
    Associate Professor of Neurology, Albert Einstein College of Medicine
    Montefiore Headache Center

    Peer Reviewer:
    Lauren R Natbony, MD
    Assistant Professor of Neurology
    Icahn School of Medicine at Mount Sinai
    Center for Headache and Facial Pain



    Sarah Vollbracht, MD Compensation for Service on Advisory Board: Promius Pharma
    Course Director Disclosures
    Mark W. Green, MD, FAAN Has nothing to disclose relevant to this activity.
    Peer Reviewer Disclosures
    Lauren R. Natbony, MD Has nothing to disclose relevant to this activity.
    PlatformQ Health Education, LLC Disclosures
    David Howard, Medical Director Has nothing to disclose relevant to this activity.
    Alissa Yost, Program Manager Has nothing to disclose relevant to this activity.


    The information provided at this CME activity is for continuing education purposes only and is not meant to substitute for the independent medical judgment of a healthcare provider relative to diagnostic and treatment options of a specific patient’s medical condition. Recommendations for the use of particular therapeutic agents are based on the best available scientific evidence and current clinical guidelines. No bias towards or promotion for any agent discussed in this program should be inferred.



    Accreditation Statement

    This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of the Icahn School of Medicine at Mount Sinai and PlatformQ Health Education. The Icahn School of Medicine at Mount Sinai is accredited by the ACCME to provide continuing medical education for physicians.

    Credit Designation Statement

    The Icahn School of Medicine at Mount Sinai designates this live activity for a maximum of 1.00 AMA PRA Category 1 Credits™. Physicians should claim only the credits commensurate with the extent of their participation in the activity.

    The Icahn School of Medicine at Mount Sinai designates this enduring activity for a maximum of 1.00 AMA PRA Category 1 Credits ™. Physicians should claim only the credits commensurate with the extent of their participation in the activity.

    Disclosure of Unlabeled Use

    The faculty of this educational activity may include discussions of products or devices that are not currently labeled for use by the FDA. Faculty members have been advised to disclose to the audience any reference to an unlabeled or investigational use.

    No endorsement of unapproved products or uses is made or implied by coverage of these products or uses in our reports. No responsibility is taken for errors or omissions in reports.

    Please refer to the official prescribing information for each product for discussion of approved indications, contraindications and warnings.

    The materials presented here are used with the permission of the authors and/or other sources. These materials do not necessarily reflect the views of the Icahn School of Medicine at Mount Sinai any of its partners, providers, and/or supporters.


    Participants will need a computer with a recent version of Adobe Flash installed, as well as an internet connection sufficient for streaming media.

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