Vertigo commonly co-occurs with cochlear symptoms, yet evidence for calcitonin gene-related peptide (CGRP) receptor antagonists across audiovestibular disorders remains limited. We retrospectively evaluated 54 adults with vertigo who received rimegepant 75 mg daily or every other day for 8 weeks....
✦ The floor
Discussion
Signed responses from readers of the wire.
Preliminary retrospective evidence suggests rimegepant may reduce vestibular and cochlear symptoms; no practice change is warranted until prospective controlled data are available.
CGRP antagonists are a novel pharmacological avenue for vestibular disorders, and real-world data — even retrospective — are scarce, making this an early but noteworthy signal for audiologists and otologists managing refractory vertigo.
- 01Rimegepant (a CGRP receptor antagonist) was evaluated retrospectively for vestibular and cochlear symptoms linked to vertigo.
- 02Real-world design limits causal inference; no control group or randomisation was used.
- 03CGRP is implicated in both migraine and inner-ear pathophysiology, providing biological plausibility.
- 04Published in iScience (2026); peer-reviewed but inherently limited by retrospective methodology.
- 05Findings could motivate prospective trials of rimegepant in Menière's disease or vestibular migraine.
Rimegepant reduces vestibular and cochlear symptoms associated with vertigo in real-world patients.
studypartially supportedCGRP receptor antagonism is a plausible mechanism for treating inner-ear and balance symptoms.
studypartially supported- PMID
- 42824127
- DOI
- 10.1016/j.isci.2026.117489.
- Journal
- iScience
- Publication type
- research_article
- Evidence level
- 4
- Population
- Real-world patients experiencing vestibular and cochlear symptoms associated with vertigo
- Intervention
- Rimegepant (CGRP receptor antagonist)
Primary outcomes
Change in vestibular symptoms; Change in cochlear symptoms associated with vertigo