Direct calcitonin gene-related peptide inhibition found to reduce acne, rosacea in patients with migraine

For patients experiencing migraine, direct calcitonin gene-related peptide (CGRP) inhibition with monoclonal antibodies (mAbs) is associated with reduced rates of acne and rosacea compared with no inhibition (topiramate) or indirect inhibition (triptans), according to a research letter published online July 10 in JAMA Dermatology.

Christopher J. Thang, from the University of Texas Medical Branch in Galveston, and colleagues examined whether CGRP inhibition is associated with reduced rates of developing acne or rosacea in a cohort study.

Patients experiencing migraines were stratified into four treatment cohorts: CGRP inhibitor (CGRPi) mAbs, CGRPi nonpeptide small molecules (gepants), triptans, and topiramate. Cohort comparisons were independently 1:1 propensity score-matched for age at index, demographics, and potential confounding medications and comorbidities using a greedy nearest-neighbor matching algorithm.

The researchers found that among patients treated with CGRPi mAbs matched with those treated with triptans, CGRPi mAb exposure was associated with a significantly reduced rate of acne and rosacea.

CGRPi mAb exposure was also associated with significantly reduced rates of acne and rosacea compared with topiramate. CGRPi mAb exposure was associated with a reduced rate of acne compared with gepants, although the difference was not statistically significant, and with a significantly reduced rate of rosacea.

"While further studies, including randomized clinical trials, are needed to examine the effects of CGRP inhibition on acne and rosacea development, the present study highlights CGRP inhibition as a novel therapeutic avenue for both conditions," the authors write.

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