Kim Yun, Yook Yeabin, Rhee Su-Jin
College of Pharmacy, Daegu Catholic University, Gyeongsan, Republic of Korea.
Department of Pharmacy, Wonkwang University College of Pharmacy, Iksan, Republic of Korea.
PLoS One. 2025 Aug 20;20(8):e0330493. doi: 10.1371/journal.pone.0330493. eCollection 2025.
Tinnitus, a distressing condition that can significantly impair quality of life, has been associated with several medications, including triptans. This study aimed to explore the relationship between tinnitus and specific migraine treatments, focusing on triptans and calcitonin gene-related peptide (CGRP) inhibitors. Data from the FDA Adverse Event Reporting System (FAERS) through the third quarter of 2023 were analyzed to calculate proportional reporting ratios (PRR) and reporting odds ratios (ROR) for migraine treatments, specifically triptans and CGRP inhibitors. Positive tinnitus signals were identified when PRRs or RORs were greater than 2.0, the lower bound of the 95% confidence interval exceeded 1.0, and at least three cases were reported. Intra- and inter-class analyses were conducted to compare tinnitus reports among individual drugs and drug classes. Among 47,615 tinnitus-related adverse events, 345 were associated with CGRP inhibitors and 183 with triptans. Positive tinnitus signals were observed for several CGRP inhibitors, except eptinezumab and atogepant, and for all triptans except sumatriptan. Inter-class analysis revealed no significant differences between triptans and CGRP inhibitors. However, intra-class analysis identified naratriptan, almotriptan, and frovatriptan as having notable tinnitus signals among triptans, while CGRP inhibitors did not exhibit strong signals for any specific drug. Using real-world data from FAERS and pharmacovigilance methods, this study identified tinnitus signals related to migraine treatments, particularly among certain triptans. These findings provide preliminary evidence for further investigation into the relationship between migraine medications and tinnitus.
耳鸣是一种令人痛苦的病症,会严重损害生活质量,它与多种药物有关,包括曲坦类药物。本研究旨在探讨耳鸣与特定偏头痛治疗方法之间的关系,重点关注曲坦类药物和降钙素基因相关肽(CGRP)抑制剂。分析了来自美国食品药品监督管理局不良事件报告系统(FAERS)截至2023年第三季度的数据,以计算偏头痛治疗药物,特别是曲坦类药物和CGRP抑制剂的比例报告比值(PRR)和报告比值比(ROR)。当PRR或ROR大于2.0、95%置信区间的下限超过1.0且报告的病例至少有三例时,确定为耳鸣阳性信号。进行了组内和组间分析,以比较各药物和药物类别之间的耳鸣报告情况。在47,615例与耳鸣相关的不良事件中,345例与CGRP抑制剂有关,183例与曲坦类药物有关。除了eptinezumab和atogepant外,几种CGRP抑制剂以及除舒马曲坦外的所有曲坦类药物均观察到耳鸣阳性信号。组间分析显示曲坦类药物和CGRP抑制剂之间无显著差异。然而,组内分析确定那拉曲坦、阿莫曲坦和夫罗曲坦在曲坦类药物中有明显的耳鸣信号,而CGRP抑制剂中没有任何一种特定药物表现出强烈信号。本研究使用来自FAERS的真实世界数据和药物警戒方法,确定了与偏头痛治疗相关的耳鸣信号,特别是在某些曲坦类药物中。这些发现为进一步研究偏头痛药物与耳鸣之间的关系提供了初步证据。