Reversible Cerebral Vasoconstriction Syndrome Exacerbation After Calcitonin Gene-Related Peptide Inhibitor...

Area of Science:

• Neurology
• Vascular Neurology
• Neuroimmunology

Background:

• Reversible cerebral vasoconstriction syndrome (RCVS) is a non-inflammatory vasculopathy.
• While often associated with good outcomes, RCVS can lead to severe neurological injury, including stroke and hemorrhage.
• Various vasoactive medications are implicated in RCVS, prompting investigation into other drug classes.

Observation:

• A case report from the University of Pennsylvania details a patient experiencing RCVS.
• This patient suffered a severe exacerbation, manifesting as multifocal ischemic stroke.
• The exacerbation occurred after the administration of fremanezumab, a calcitonin gene-related peptide (CGRP) inhibitor.

Findings:

• The study presents a case where fremanezumab use coincided with a severe RCVS event.
• This event involved multifocal ischemic stroke, a serious complication of RCVS.
• The temporal relationship suggests a potential role for CGRP inhibitors in RCVS exacerbation.

Implications:

• The findings suggest that CGRP inhibitors, such as fremanezumab, should be considered as a potential trigger for RCVS.
• Further research is needed to establish a definitive causal link between CGRP inhibitors and RCVS.
• Clinicians should be aware of this potential association when prescribing CGRP inhibitors.