A MAJOR clinical trial has found that candesartan significantly reduces migraine days in adults with episodic migraine, providing a well-tolerated preventive option for sufferers. The results mark an encouraging advance for migraine management and the search for effective, evidence-based treatments.
Seeking New Answers in Migraine Care
Migraine remains a major public health burden, with relatively few preventive treatments offering both safety and robust efficacy. Earlier studies hinted at benefits from candesartan, an angiotensin receptor blocker, but larger trials were needed to clarify its impact. This new research harnessed a rigorous triple-blind, placebo-controlled design across specialised centres to evaluate the role of candesartan in reducing migraine frequency and improving patient well-being.
Efficacy and Safety: Study Outcomes
In total, 457 patients with episodic migraine were randomly assigned to candesartan 16 mg, candesartan 8 mg, or placebo, receiving daily therapy for 12 weeks. Baseline migraine frequency averaged 5.7 days per month. By weeks 9–12, those taking candesartan 16 mg saw a mean reduction of 2.04 migraine days (95% CI 1.65–2.41; p<0.0001), compared with just 0.82 days (95% CI 0.38–1.23; p=0.0003) for placebo, demonstrating a difference of -1.22 days in favour of candesartan 16 mg (95% CI –1.75 to –0.70; p<0.0001). Dizziness was the most frequently reported adverse event with candesartan (30% vs 13% in placebo), while serious events and withdrawals due to side effects were rare and comparable between groups.
Migraine Prevention: Next Steps in Practice
Candesartan 16 mg once daily emerges from this phase 2 trial as an effective and well-tolerated preventive therapy for episodic migraine, expanding clinical choice for practitioners. While the findings strongly support candesartan’s use in appropriate patients, future research and real-world registry data are essential to fully establish its long-term benefits and optimal role in migraine management.
Reference
Øie LR et al. Candesartan versus placebo for migraine prevention in patients with episodic migraine: a randomised, triple-blind, placebo-controlled, phase 2 trial. The Lancet Neurology. 2025;24(10):817-27.
