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Could calcitonin gene-related peptide inhibitors prevent status epilepticus?
Journal article   Open access   Peer reviewed

Could calcitonin gene-related peptide inhibitors prevent status epilepticus?

Michael Nsaka, Noor Baban, Sepideh Allahdadian, Armin Scheffler, Diana Lindner, Dagny Holle and Alain Lekoubou
Epilepsia (Copenhagen), Forthcoming
13 Aug 2026
DOI: https://doi.org/10.1002/epi.70436
PMID: 42596577
Featured in Collection :   Drexel's Newest Publications
url
https://doi.org/10.1002/epi.70436View
Published, Version of Record (VoR) Open

Abstract

status epilepticus migraine neuroinflammation CGRP inhibitors Epilepsy
Calcitonin gene-related peptide (CGRP) inhibitors modulate pain and neuroinflammation, a recognized contributor to epileptogenesis and status epilepticus (SE). We examined the association between CGRP inhibitor use and SE hospitalization in epilepsy patients with comorbid migraine. Using TriNetX (130 healthcare organizations), we identified patients with epilepsy from May 2018 through May 2026, and propensity-matched cohorts for age, sex, race, anti-seizure medications (ASMs), migraine diagnosis, migraine treatments, and cognitive impairment. The primary outcome was SE occurrence. Following matching, 17 738 patients were on CGRP inhibitors and 18 594 were not. SE occurred in 427 (2.41%) and 860 (4.63%) patients, respectively. Mean age (±SD) was 48.4 ± 14.9 vs 48.9 ± 17.0 years. Risk difference was -2.2% (95% confidence interval [CI]: -2.6% to -1.8%, p < .001), risk ratio 0.52 (95% CI: 0.46-0.58), and odds ratio 0.51 (95% CI: 0.45-0.57). SE-related hospital visits were significantly fewer in the CGRP inhibitor group (t = -6.60, p < .001). CGRP inhibitor use was associated with reduced SE occurrence and hospitalization, supporting further investigation in patients with comorbid migraine and epilepsy.

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