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Treating Menière's disease with rimegepant
Stefan C A Hegemann1,2, Angela Schell3,4
1Faculty of Medicine, University of Zurich, Zurich, Switzerland.
Calcitonin gene-related peptide (CGRP) may drive Menière's disease. A new CGRP antagonist, rimegepant, effectively resolved Menière's symptoms in five patients, suggesting a promising new treatment.
Area of Science:
- Neuroscience
- Otolaryngology
- Pharmacology
Background:
- Menière's disease is a debilitating inner ear disorder.
- A recent hypothesis links Menière's disease pathogenesis to calcitonin gene-related peptide (CGRP) overactivity.
- CGRP antagonists are approved for migraine treatment.
Purpose of the Study:
- To investigate the hypothesis that CGRP is involved in Menière's disease.
- To evaluate the efficacy of rimegepant, a CGRP antagonist, in patients with Menière's disease and migraine.
Main Methods:
- Six patients with co-existing Menière's disease and migraine were enrolled.
- Two patients received a single 75 mg dose of rimegepant for acute Menière's attacks.
- Five patients received 75 mg rimegepant every other day for preventive therapy.
Main Results:
- Acute Menière's symptoms resolved approximately 30 minutes earlier than migraine symptoms in the two patients treated acutely.
- Migraine symptoms were reduced in all five patients on preventive therapy.
- All five patients experienced complete resolution of Menière's symptoms with preventive rimegepant therapy for up to eight months.
Conclusions:
- The findings support the role of CGRP in Menière's disease pathogenesis.
- Inhibition of CGRP signaling via rimegepant appears to be a promising therapeutic strategy for Menière's disease.
- Further research is warranted to confirm these preliminary findings.
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