Online interest in calcitonin gene-related peptide-therapies: An infodemiology study using Google trends.

OBJECTIVE To evaluate changes in public interest in calcitonin gene-related peptide therapies associated with major product lifecycle milestones using online search data from the United States and Europe.

BACKGROUND Calcitonin gene-related peptide therapies have transformed migraine treatment, but the impact of key product lifecycle milestones on public awareness remains unclear. As patients increasingly turn to online platforms for health information, events such as trial publications, regulatory approvals, commercial launches, and advertising campaigns may drive search activity and signal broader awareness.

METHODS We conducted a retrospective ecological infodemiology study using a quasi-experimental interrupted time-series design with monthly Google Trends data (January 2017-July 2025). Search volume index (0-100 scale) was assessed for seven CGRP-therapies. Milestone events (trial publications, regulatory approvals, commercial launches, and media exposure) were defined a priori as potential drivers of digital impact. We evaluated immediate and sustained changes in search interest following major milestones over time. The primary analysis included all therapies in the United States; secondary analyses evaluated erenumab across five European countries (Germany, France, Italy, Spain, and United Kingdom).

RESULTS In the United States, commercial launch was associated with significant immediate increases in search interest for erenumab (β = 102.54; 95% confidence interval [CI], 17.05-188.02, p = 0.021) and galcanezumab (brand search term) (β = 42.36; 95% CI, 15.80-68.91, p = 0.002). Sustained post-launch growth was observed for fremanezumab (brand search term) (β = +0.50/month; 95% CI, 0.27-0.73, p < 0.001), eptinezumab (β = +0.45/month; 95% CI, 0.26-0.64, p < 0.001), rimegepant (brand search term) (β = +0.97/month; 95% CI, 0.47-1.47, p < 0.001), atogepant (brand search term) (β = +1.28/month; 95% CI, 0.70-1.85, p < 0.001), and ubrogepant (brand search term) (β = +0.59/month; 95% CI, 0.42-0.77, p < 0.001). Media exposure was associated with significant immediate increases for erenumab (β = 94.33; 95% CI, 11.17-177.50, p = 0.029) and ubrogepant (β = 29.77; 95% CI, 11.12-48.41, p = 0.003). Regulatory approvals and trial publications were not consistently associated with significant changes in search interest. In Europe, commercial launch was associated with significant immediate increases for erenumab (generic search term) in Italy (β = 126.82; 95% CI, 62.12-191.52, p < 0.001), erenumab (brand search term) in Italy (β = 142.98; 95% CI, 23.88-262.08, p = 0.021) and the United Kingdom (β = 69.44; 95% CI, 6.71-132.16, p = 0.033). Post-launch trends were generally negative across countries, indicating gradual declines after initial spikes.

CONCLUSIONS Commercial launch was the most consistent driver of public search interest in CGRP-targeting therapies. Media exposure produced additional increases in selected cases, whereas regulatory approvals and clinical trial publications had limited measurable impact. These findings underscore the dominant role of commercial and consumer-facing communication in shaping public awareness of new migraine treatments.