CGRP-Targeted Therapy in Vestibular Migraine-How Strong Is the Evidence?
Abstract
Background: Medications for migraine prevention targeting the calcitonin gene-related peptide (CGRP) pathway have substantially reduced symptom burden in many patients that have failed previous treatment strategies. In contrast, data on treatment response to monoclonal antibodies (mAbs) or small molecule receptor antagonists (gepants) in patients suffering from vestibular migraine (VM) is scarce and preliminary.
Methods: We discuss the existing literature on VM-prevention using mAbs and gepants with a special focus on biases and limitations such as small sample sizes, retrospective study design, lack of blinding, and patient selection.
Results: Studies identified (n = 8) assessed different mAbs and gepants and generally reported improvement of vestibular symptoms and scores used, but were often of small sample size and lacked blinding and control groups. In a single randomized controlled trial, a significant treatment response to galcanezumab was identified, with a medium to large effect size (ranging between 0.56 and 1.02) for dizzy days reported and on scores applied (dizziness handicap inventory [DHI] and Vestibular Migraine Patient Assessment Tool and Handicap Inventory [VM-PATHI]).
Conclusions: Data on anti-CGRP treatments for VM remain limited, and efficacy established in headache migraine cannot be straightforwardly extrapolated to VM given differences in underlying pathophysiology. There remains a risk that initial effect estimates may diminish over time, with early…
Read the paper
Related studies
- Calcium Ions in the Physiology and Pathology of the Central Nervous System
- AI-powered in silico twins: redefining precision medicine through simulation, personalization, and predictive healthcare
- In silico functional, structural and pathogenicity analysis of missense single nucleotide polymorphisms in human MCM6 gene
- In Silico drug repurposing pipeline using deep learning and structure based approaches in epilepsy
- Targeting serotonin receptors with phytochemicals – an in-silico study
- In silico exploration of anti-prostate cancer compounds from differential expressed genes
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.