JAMA Neurology

JAMA Neurol. Published online February 26, 2024. doi:10.1001/jamaneurol.2023.5835
Michel Lanteri-Minet; Shuu-Jiun Wang; Paolo Martelletti

To the Editor In a recent JAMA Neurology Viewpoint,1 Porreca and Dodick raised an important issue by discussing gender differences in outcomes of calcitonin gene-related peptide (CGRP) receptor antagonists in migraine treatment. Their point of view is supported by a pooled pivotal trial data analysis, which showed that there was no therapeutic gain seen in the male population for migraine short-term treatment with either ubrogepant or rimegepant. Their point of view is also supported by a body of experimental animal and human data showing that the involvement of CGRP is probably sexually dysmorphic. Such a sexual dysmorphism implies that the influence of gender should affect both gepants and monoclonal antibodies targeting CGRP (CGRP-mAbs). The discussion on CGRP-mAbs data is absent from Porreca and Dodick’s Viewpoint.1

Patient Sex in Prescribing CGRP Receptor Antagonists for Migraine