Cabral Gonçalo
Neurology Department, Hospital de Egas Moniz, Unidade Local de Saúde de Lisboa Ocidental, Rua da Junqueira 126, Lisboa, 1349-019, Portugal.
Neurol Sci. 2025 Jul;46(7):3333-3334. doi: 10.1007/s10072-025-08121-x. Epub 2025 Mar 19.
Menstrual migraine (MM) is a debilitating migraine subtype associated with hormonal fluctuations, often resistant to conventional treatments. Gepants, novel calcitonin generelated peptide (CGRP) receptor antagonists, and ditans, serotonin 5-HT1F receptor agonists, offer potential alternatives to triptans due to their non-vasoconstrictive properties. However, evidence supporting their effectiveness in MM remains limited. While studies suggest gepants may reduce perimenstrual migraine severity and ditans provide acute relief, their overall efficacy compared to triptans remains uncertain. Cost and side effect profiles further complicate their widespread adoption. This letter discusses the current state of evidence for gepants and ditans in MM, highlighting the need for further large-scale, real-world studies to clarify their role in treatment strategies.
月经性偏头痛（MM）是一种与激素波动相关的使人衰弱的偏头痛亚型，通常对传统治疗有抗性。 gepants类药物，即新型降钙素基因相关肽（CGRP）受体拮抗剂，以及ditans类药物，即5-羟色胺（5-HT1F）受体激动剂，因其非血管收缩特性，提供了曲坦类药物的潜在替代方案。然而，支持它们在MM中有效性的证据仍然有限。虽然研究表明gepants类药物可能降低围经期偏头痛的严重程度，ditans类药物能提供急性缓解，但与曲坦类药物相比，它们的总体疗效仍不确定。成本和副作用情况进一步使它们的广泛应用复杂化。这封信讨论了gepants类药物和ditans类药物在MM中的现有证据状况，强调需要进一步开展大规模、真实世界研究，以阐明它们在治疗策略中的作用。
