Modern medicine is constantly evolving, offering new approaches to the diagnosis and treatment of various diseases. In this article, we will review the latest advances and current data concerning such diverse conditions as migraine, various forms of gastritis, and cyclic vomiting syndrome, based on recent scientific publications.
Modern Migraine Treatment Methods: CGRP Inhibitors
Migraine is a debilitating neurological disorder that significantly reduces patients' quality of life. A breakthrough in its preventive treatment is associated with the emergence of monoclonal antibodies targeting the calcitonin gene-related peptide (CGRP), as well as CGRP receptor antagonists (gepants). These drugs, such as erenumab, galcanezumab, and rimegepant, have shown high efficacy in clinical practice [1, 7].
Efficacy and Tolerability
- An observational study was conducted in Egypt involving 80 patients (62 with chronic and 18 with episodic migraine) receiving erenumab, galcanezumab, or rimegepant. The results showed a significant improvement in clinical outcomes, confirming the efficacy of these drugs in real-world practice [1].
- A systematic review of post-marketing surveillance data confirmed that CGRP inhibitors are generally well tolerated. However, like any medications, they can cause side effects that require attention [7].
- Rimegepant, a CGRP receptor antagonist, also demonstrated efficacy in the acute treatment of vestibular migraine. A study involving 18 patients showed a reduction in the severity of symptoms such as dizziness, imbalance, nausea/vomiting, photophobia/phonophobia, and headache as early as 30 minutes after drug administration, with significant improvement in most symptoms after 2 hours [8].
Rare Side Effects
Despite good tolerability, adverse reactions may occur in rare cases. For example, a case of symptoms resembling ocular myasthenia gravis was described in a 46-year-old woman with chronic migraine who received erenumab for more than three years. Symptoms (diplopia, intermittent ptosis, transient dysarthria) disappeared after discontinuation of erenumab and recurred upon re-administration, but without recurrence of myasthenia-like manifestations while continuing pyridostigmine therapy. This highlights the need for clinicians to be vigilant regarding rare, late-onset, and reversible complications [2].
Various Forms of Gastritis: From Immune to Phlegmonous
Gastritis is inflammation of the gastric mucosa, which can have diverse causes and manifestations. Recent studies shed light on rare forms and new approaches to treatment.
Immune-Mediated Gastritis
Immune-mediated adverse events (irAEs) are associated with the use of immune checkpoint inhibitors (ICIs) in oncology. Gastritis as an irAE is a rare but potentially serious complication. A case of a 75-year-old woman is described who developed anorexia, nausea, and vomiting after six cycles of cemiplimab (ICI). Endoscopy revealed erythema and edema of the gastric mucosa, and histological examination showed infiltration by CD8-positive lymphocytes, confirming the diagnosis of immune-mediated gastritis [3].
Phlegmonous Gastritis
Phlegmonous gastritis (PG) is a rare but potentially fatal bacterial infection of the gastric wall that progresses rapidly. A case of a 66-year-old man is described who developed PG complicated by septic shock after endoscopic mucosal resection (EMR) for a gastric adenoma. A characteristic sign is high fever, whereas abdominal pain may be absent, which complicates early diagnosis. Lack of timely recognition often leads to systemic sepsis and high mortality. In this case, the infection was caused by Streptococcus parasanguinis and Streptococcus salivarius, and the patient was successfully treated conservatively with meropenem [4].
Chronic Atrophic Gastritis
Chronic atrophic gastritis (CAG) is characterized by thinning of the gastric mucosa and loss of glands. A study of the efficacy of combination therapy in patients with CAG showed that the combination of "rapid-fire needling" and Xiaoliu Jin Jianwei decoction significantly improves gastrointestinal symptoms and histopathological changes of the gastric mucosa. In the combination therapy group, a decrease in GSRS (gastrointestinal symptom rating scale) scores, histopathological scores, high-sensitivity C-reactive protein (hs-CRP) and tumor necrosis factor-α (TNF-α) levels was observed, as well as a higher overall efficacy (93.40% vs. 71.60% in the control group) [5].
Cyclic Vomiting Syndrome: Challenges in Diagnosis and Therapy
Cyclic vomiting syndrome (CVS) is characterized by recurring episodes of severe vomiting. This condition is often diagnosed with a delay: in one study, the average age of symptom onset in children was 5.7 years, and diagnosis was 8.0 years, indicating difficulties in recognizing CVS. The prevalence of CVS ranges from 0.3% to 2% [6].
The pathophysiology, prognosis, and natural history of CVS require further study. There are various abortive and preventive treatment methods, but randomized controlled trials on abortive therapy for CVS have not yet been conducted. Current recommendations for the treatment of CVS in children are detailed in the 2025 guidelines of the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN) [6].
Conclusion
The presented studies demonstrate the dynamic development of medical knowledge in the fields of neurology and gastroenterology. From new targeted drugs for migraine treatment to comprehensive approaches to gastritis therapy and an improved understanding of cyclic vomiting syndrome, each discovery brings us closer to more effective and personalized patient care.
Sources
- [1] Efficacy, tolerability, and barriers to the use of anti-CGRP drugs among migraine patients in Egypt: real-world experience. (Frontiers in neurology, 2026) https://pubmed.ncbi.nlm.nih.gov/42394926/
- [2] Late-onset ocular myasthenia-like symptoms during erenumab therapy for chronic migraine: a case report. (Biologics : targets & therapy, 2026) https://pubmed.ncbi.nlm.nih.gov/41808843/
- [3] A case of irAE gastritis induced by cemiplimab administration. (Fujita medical journal, 2026) https://pubmed.ncbi.nlm.nih.gov/41641121/
- [4] Case report: phlegmonous gastritis following endoscopic mucosal resection for a non-Helicobacter pylori foveolar-type gastric adenoma with a raspberry-like appearance. (Clinical journal of gastroenterology, 2026) https://pubmed.ncbi.nlm.nih.gov/41920483/
- [5] Rapid-fire needling combined with Xiaoliu Jin Jianwei decoction ameliorates gastrointestinal symptoms and gastric mucosal lesions in chronic atrophic gastritis. (American journal of translational research, 2026) https://pubmed.ncbi.nlm.nih.gov/42007096/
- [6] Cyclic vomiting syndrome. (Brain & development, 2026) https://pubmed.ncbi.nlm.nih.gov/41719916/
- [7] Post-marketing safety of CGRP monoclonal antibodies and gepants: a systematic review of spontaneous reporting system data. (Headache, 2026) https://pubmed.ncbi.nlm.nih.gov/41834180/
- [8] Efficacy of rimegepant for the acute treatment of vestibular migraine. (Scientific reports, 2026) https://pubmed.ncbi.nlm.nih.gov/41699085/
Disclaimer: The information in this article is for reference purposes only and does not constitute a guide to self-treatment. Before starting any treatment or changing current therapy, be sure to consult a qualified medical professional.