New-onset alopecia areata during calcitonin gene-related peptide inhibitor therapy: first reported case

Dear Editor, Calcitonin gene-related peptide (CGRP) is a neuropeptide with potent vasodilatory effects and a key role in trigeminovascular signaling, underlying the pathogenesis of migraine. Consequently, the inhibition of CGRP activity has been demonstrated to reduce the incidence of acute migraine attacks. Based on this evidence, monoclonal antibodies against CGRP or its receptor have been approved by the European Medicines Agency for prevention of both episodic and chronic migraine. Among CGRP inhibitors, galcanezumab has also been authorized for the treatment of episodic cluster headache. Since the advent of CGRP inhibitors, several cases of drug-induced telogen effluvium have been reported, with incidence rates ranging from 1.10% to 7.23%. However, to the best of our knowledge, alopecia areata (AA) associated with CGRP inhibition remains undescribed in the literature. [...]