Hair

Hair loss from CGRP Monoclonal Antibodies — Donovan Hair Clinic


New study identifies hair loss in 2 % of patients using CGRP monocloncal antibodies

Introduction

Evers et al, 2023

Authors from Germany described 6 patients out of 279 patients treated  monoclonal CGRP antibodies over a 3 year period. That equates to 2.2 %

All patients were female patients with chronic migraine. Ages of patients ranged from 40-62 years. Hair loss due to iron deficiency and thyroid problems was ruled out.  All patients started with erenumab. 5 of the patients had excessive shedding and 1 patient developed a visible hair loss (rather than a shedding).

The hair loss started between 1 and 4 weeks after starting treatment with the monoclonal CGRP antibody. All patients switched to another monoclonal CGRP antibody. In four of these patients, the effluvium stopped completely! In the other two patients’ alopecia or effluvium also occurred with the second monoclonal CGRP antibody. Of these two patients, one stopped treatment with monoclonal CGRP antibodies and one switched to a third monoclonal CGRP antibody after which effluvium finally stopped.

Discussion

This is a helpful paper which puts hair loss at around 2-3 % of patients treated with erenumab. This drug was FDA approved in 2018 and is marketed in many counties as Aimovig. It was the first CGRP monoclonal antibody to be approved.

This study teaches us that it’s worth making a switch to another anti-CGRP type treatment if shedding is troublesome or hair loss has occurred. In many patients, this switch is expected to resolve the hair loss issue. If not, another switch is worth it!

REFERENCE

Evers S and Wald S. Effluvium and alopecia associated with monoclonal calcitonin gene-related peptide antibody use. Headache. 2023 Jan;63(1):165-167.


Dr. Jeff Donovan is a Canadian and US board certified dermatologist specializing exclusively in hair loss.
To schedule a consultation, please call the Whistler office at 604.283.1887




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