[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-detail-209120-en":3,"doc-seo-209120-105":30,"detail-sidebar-cat-0-en-105":91},{"code":4,"msg":5,"data":6},0,"success",{"doc_id":7,"user_id":8,"nickname":9,"user_avatar":10,"doc_module":4,"category_id":11,"category_name":12,"doc_title":13,"doc_description":14,"doc_content":15,"file_id":16,"file_url":17,"file_type":18,"file_size":19,"view_count":20,"is_deleted":4,"is_public":20,"is_downloadable":20,"audit_status":20,"page_count":21,"language":22,"language_code":23,"site_id":24,"html_lang":23,"table_of_contents":25,"faqs":26,"seo_title":27,"seo_description":14,"update_tm":28,"read_time":29},209120,1099514068035,"Ezra","https://ap-avatar.wpscdn.com/davatar_276721f389ce27ea32af1340a28f341c",8,"Research & Report","Early Experience Treating Vestibular Migraine With Small Molecule CGRP Antagonists","Objectives focused on whether blocking calcitonin gene-related peptide (CGRP) via small-molecule CGRP antagonists (gepants) could help prevent or treat vestibular migraine (VM). A retrospective case series evaluated adult VM patients receiving ubrogepant, rimegepant, atogepant, or zavegepant. Patients completed VM-PATHI and DHI plus VM and gepant-experience surveys. Seventeen patients were included; most reported relief of their worst symptom and a majority described substantial symptom management benefit, with no serious adverse events observed.","Original Research—Otology and Neurotology            \nEarly Experience Treating Vestibular Migraine With Small Molecule CGRP Antagonists  \nEvan J. Patel, MD , Kali Koziol, PA-C, and Jeffrey D. Sharon, MD  \nOtolaryngology– Head and Neck Surgery 2026, Vol. 00(00) 1–4  \n© 2026 American Academy of Otolaryngology-Head and Neck Surgery Foundation.  \nDOI: 10.1002/ohn.70196  \n[http://otojournal.org](http://otojournal.org)  \nAbstract  \nObjectives. Blocking the activity of calcitonin gene-related peptide (CGRP) has emerged as a possible method for the prevention of vestibular migraine (VM). We aimed to investigate the effectiveness of small molecule CGRP antagonists (gepants) for the treatment of VM.  \nStudy Design. Retrospective case series.  \nSetting. Tertiary academic center.  \nMethods. Adult patients diagnosed with VM who were treated with gepants were included. The gepants used included ubrogepant, rimegepant, atogepant, and zavegepant. A set of questionnaires was sent to patients including the Vestibular Migraine Patient Assessment Tool and Handicap Inventory (VM-PATHI), Dizziness Handicap Inventory (DHI), a survey regarding the details of their VM, and a survey focused on their experience with gepants.  \nResults. A total of 17 patients with VM who used gepants were included. Median age was 54.1 (SD 9.3) and the majority were female (70.6%). Vertigo was the most bothersome symptoms for 47.1% of patients. The most common gepant used was rimegepant (88.2%) followed by ubrogepant (58.8%), atogepant (23.5%), and zavegepant (5.9%). Seven patients (41.2%) took gepants in an abortive fashion, 3 patients (17.6%) used them as a preventative medication and 7 patients (41.2%) tried them as both a preventative or abortive medication. The majority of patients (76.5%) experienced relief of their most bothersome symptom after taking a gepant and 84.6% of this cohort claimed these medications helped quite a lot to manage their symptoms of VM. No serious adverse events were observed.  \nConclusions. Gepants are well-tolerated by patients and are promising agents for the treatment of vestibular migraine.  \nKeywords  \nCGRP, gepant, vestibular migraine  \nReceived October 22, 2025; accepted February 23, 2026.  \nC  \nalcitonin gene‐related peptide (CGRP) is aneuropeptide that has been implicated in the pathophysiology of migraine. Release of this  \nmolecule has been shown to cause mast cell degranulation, vasodilation, and pain transmission.1 Previous studies have demonstrated that CGRP levels are elevated in patients with chronic migraine and spike during migraine attacks. Infusion of CGRP can also cause migraine episodes.2  \nBlocking the activity of this neuropeptide has emerged as a promising method for the prevention of migraine. Initial studies demonstrated the effectiveness of CGRPmonoclonal antibodies which are administered by subcutaneous injection on a monthly basis.3 Small molecule CGRP antagonists (gepants) have also been developed with favorable early results and limited side effects.4‐6  \nVestibular migraine (VM) is a subtype of migraine which causes recurrent vestibular symptoms associated with migraine features (photophobia, phonophobia, and nausea) .7 Many of the same pharmaceutical agents for migraine are used for VM. CGRP antagonists in particular have been an area of investigation as CGRP has been shown to be expressed in the central and peripheral vestibular system.8‐10  \nInitial studies investigating blockade of the CGRP pathway for VM have demonstrated the effectiveness of monoclonal antibodies as a preventative measure.11‐13 To our knowledge, the efficacy of gepants for VM has not yet been assessed. In this study, we report our early experience with oral and intranasal gepants to treat VM.  \nMethods  \nThis study was approved by the University of California– San Francisco institutional review board (\\#24‐41412) . A retrospective case series was conducted on all adult patients diagnosed with probable VM or definite VM by Barany Society","cbCaio7YHeMSjzyj","https://ap.wps.com/l/cbCaio7YHeMSjzyj","pdf",169729,1,4,"English","en",105,"# Abstract\n## Objectives\n## Study Design\n## Methods\n## Results\n## Conclusions\n# Methods","[{\"question\":\"What was the study objective regarding CGRP antagonists for vestibular migraine?\",\"answer\":\"To investigate the effectiveness of small-molecule CGRP antagonists (gepants) for treating vestibular migraine by blocking CGRP activity.\"},{\"question\":\"Which gepants were included in the patient treatment and assessment?\",\"answer\":\"The study included ubrogepant, rimegepant, atogepant, and zavegepant, with patients reporting outcomes through VM-PATHI, DHI, and additional surveys.\"},{\"question\":\"What were the main findings on symptom relief and safety?\",\"answer\":\"Most patients experienced relief of their most bothersome symptom and many reported these medications helped quite a lot to manage VM symptoms, and no serious adverse events were observed.\"}]","Early Experience Treating Vestibular Migraine With Small Molecule CGRP Antagonists | 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was the study objective regarding CGRP antagonists for vestibular migraine?","Question",{"text":75,"@type":76},"To investigate the effectiveness of small-molecule CGRP antagonists (gepants) for treating vestibular migraine by blocking CGRP activity.","Answer",{"name":78,"@type":73,"acceptedAnswer":79},"Which gepants were included in the patient treatment and assessment?",{"text":80,"@type":76},"The study included ubrogepant, rimegepant, atogepant, and zavegepant, with patients reporting outcomes through VM-PATHI, DHI, and additional surveys.",{"name":82,"@type":73,"acceptedAnswer":83},"What were the main findings on symptom relief and safety?",{"text":84,"@type":76},"Most patients experienced relief of their most bothersome symptom and many reported these medications helped quite a lot to manage VM symptoms, and no serious adverse events were 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