Effectiveness and clinical predictors of rimegepant for acute vertigo in vestibular migraine: A real-world cohort study

In view of limited evidence-based acute treatments for spontaneous vertigo in vestibular migraine, this real-world cohort study assessed the effectiveness of rimegepant for acute vestibular migraine-related vertigo and factors associated with treatment response.MethodsClinical data were retrospectively collected from 86 patients with documented vestibular migraine treated with rimegepant 75 mg orally disintegrating...

✦ Clinical Takeaway ✦

Audiologists and vestibular specialists managing vestibular migraine patients should be aware that rimegepant shows real-world effectiveness for acute spontaneous vertigo episodes, and certain clinical predictors may help identify the best candidates — consider coordinating with neurology for prescribing.

✦ Why It Matters ✦

Vestibular migraine is among the most common causes of episodic vertigo and has limited acute treatment options; real-world evidence for rimegepant fills a meaningful evidence gap.

✦ Key Points ✦

01Rimegepant demonstrated effectiveness for acute spontaneous vertigo attacks in vestibular migraine patients.
02Clinical predictors of response were identified, potentially allowing patient selection in practice.
03This is a real-world cohort study, not an RCT, which limits causal inference.
04Published in Cephalalgia (DOI 10.1177/03331024261463533).
05Vestibular migraine is a leading but under-treated cause of episodic vertigo in adults.

✦ Claims & Evidence ✦

ClaimEvidenceSupport

Rimegepant is effective for treating acute spontaneous vertigo in vestibular migraine patients.

studypartially supported

Specific clinical features can predict which vestibular migraine patients respond best to rimegepant.

studypartially supported

✦ Research metadata ✦

PMID: 42377393
DOI: 10.1177/03331024261463533.
Journal: Cephalalgia
Publication type: research_article
Evidence level: 2b
Population: Patients with vestibular migraine experiencing acute spontaneous vertigo attacks
Intervention: Rimegepant for acute treatment of spontaneous vertigo in vestibular migraine

Primary outcomes

Effectiveness of rimegepant in reducing acute vertigo severity; Identification of clinical predictors of treatment response

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