On May 17, the US Food and Drug Administration approved a first-in-class monoclonal antibody drug to prevent migraine headache. Amgen's Aimovig (erenumab) is the first biologic drug to target the calcitonin-gene-related peptide (CGRP) receptor. CGRP signaling contributes to migraine pain, by inducing blood vessel dilation and pain sensitization on the trigeminal ganglion, outside the central nervous system. The antibodies act to prevent migraine pain by blocking CGRP. Unlike existing small-molecule CGRP antagonists used to treat acute migraine episodes, direct targeting of the peptide or its receptor with a monoclonal antibody is more specific, with few or no apparent adverse effects, and can be used as prevention (Nat. Biotechnol. 36, 207–208, 2018). In phase 2 and 3 studies in chronic and episodic migraine, Aimovig significantly reduced monthly migraine days and use of acute migraine medications compared with placebo. In an ongoing open-label extension study in episodic migraine (4–14 headache days per month), these effects were sustained for up to 15 months. Also, a dedicated phase 3b study (LIBERTY) in individuals with episodic migraine who had failed two to four prior treatments showed that those taking Aimovig had nearly threefold higher probability of cutting their migraine days by half or more compared with placebo. Anticipating a crowded field for CGRP biologics, Amgen set Aimovig's price at $6,900 per year—considerably lower than analysts' expectations. Other monoclonal antibodies targeting the CGRP pathway in late-stage development include Petach Tikva, Israel–based Teva Pharmaceuticals' eptinezumab, Alder Biopharmaceuticals' fremanezumab and Eli Lilly's galcanezumab. Unlike Aimovig, these antibodies target the peptide itself. Amgen is partnering with Novartis to co-commercialize Aimovig in the US. In the deal, the Basel-based pharma also gained exclusive commercialization rights to the drug in Europe, Canada and elsewhere. Following on the heels of the US approval, on June 1, the European Medicines Agency's Committee for Medicinal Products for Human Use recommended granting a marketing authorization for Aimovig.