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The signaling molecule pituitary adenylate cyclase–activating polypeptide (PACAP) is a strong vasodilator found in many areas important for migraine, such as the hypothalamus and the trigeminal and sphenopalatine ganglion. Experimental infusions of PACAP may trigger migraine-like headache, revealing its potential as a target for preventing migraine attacks. Researchers conducted a phase 2a, double-blind, manufacturer-funded efficacy and safety trial of Lu AG09222, a non–FDA-approved monoclonal antibody to PACAP. They randomized 237 adults with migraine who had failed to respond to 2 to 4 prior preventive treatments (mean number of baseline migraine days per month, 16.7) to either 750 mg or 100 mg of Lu AG09222 or placebo. The primary endpoi…