419 Effects of anti-calcitonin gene related peptide migraine medications on psoriasis and atopic dermatitis severity

Calcitonin gene-related peptide (CGRP), a neuropeptide on endothelial and immune cells, is found at elevated levels in individuals with migraines, psoriasis (PS), and atopic dermatitis (AD). Recently, three anti-CGRP medications were approved for migraine prophylaxis. Few studies have investigated the effects of these medications on other diseases. We hypothesized that anti-CGRP medications may improve AD or PS. Using retrospective analysis of electronic medical records (EMR), we identified patients diagnosed with migraines and AD or PS (ICD-10) who were prescribed anti-CGRP medications. Subjects were then interviewed by phone to gather subjective assessments of changes in their migraines and skin disease with anti-CGRP medications. Nineteen subjects were identified (10 (52.6%) = AD; 9 (47.4%) = PS), of which 13 consented (8 (61.5%) = AD; 5 (38.5%) = PS) to the phone interview. Three subjects (2 = AD; 1 = PS) reported no duration of anti-CGRP treatment and did not complete the interview. Average duration of anti-CGRP treatment was 7.2 ± 6.2 months, with 72.7% of subjects reporting improvement in migraines and only AD subjects reporting improvement in their skin disease (2/6 (33%) = AD; 0/4 (0%) = PS). No PS subjects reported improvement in their skin disease. One AD subject reported 40% improvement in itch; another reported 100% improvement in pain. Half of AD subjects reported fewer physician visits for their skin disease. Overall, we observed a modest reduction in AD severity with the use of anti-CGRP medications in subjects with migraines and AD. These results encourage further investigation of anti-CGRP medications for AD patients, especially those who primarily experience pain as a symptom of their disease. We are optimistic that as more patients are prescribed anti-CGRP medications for migraines, more robust data will become available to verify our findings.