xRead - Episodic Vertigo (January 2026)

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15264610, 2024, 10, Downloaded from https://headachejournal.onlinelibrary.wiley.com/doi/10.1111/head.14835 by University Of Michigan Library, Wiley Online Library on [21/10/2025]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License

HEADACHE

Assessed for Eligibility:680

Excluded: 627

• • • • • • • • • • • •

Complex medical history Secondary vestibular diagnosis ( N = 232) ( N = 46) Prior or current CGRP use ( N = 44) Severe psychiatric disease ( N = 11) Other neurologic disease ( N = 37) Prior e >4 failed prophylactics ( N = 11) ar surgery ( N = 14)

Pregnant/breastfeeding English fluency ( N = 13)

( N = 5)

Symptoms too infrequent ( N = 46) No response/not interested ( N = 183)

Other ( N = 83)

Signed Consent: 53

Excluded: 13 • Did not meet DDD/VM-PATHI baseline score ( N =11) • Was on protocol in baseline when study terminated early ( N =2)

Randomized: 40

• On protocol when study terminated early ( N =1), finished SV2

• Withdrew from study due to unrelated medical problems ( N =1) after SV2

Galcanezumab ITT: 17

Placebo- ITT: 21

N =38

• Treated with placebo at SV2, accidentally crossed over to placebo for SV3 ( N =2)

Placebo PP: 19

Galcanezumab PP: 17

N =36

FIGURE 1 CONSORT diagram for the INVESTMENT trial. CGRP, calcitonin gene–related peptide; CONSORT, Consolidated Standards of Reporting Trials; DDD, definite dizzy day; INVESTMENT, Investigating Vestibular Migraine Emgality Treatment; ITT, intent to treat; PP, per protocol; SV, study visit; VM-PATHI, Vestibular Migraine Patient Assessment Tool and Handicap Inventory.

words, those in the galcanezumab arm had a 63% reduction in the number of DDDs in the third month of treatment, compared to a 31% reduction for those in the placebo arm. We also found that

galcanezumab improved the DHI during the 3 months of treatment by 22 points, compared to an 8.3-point improvement for placebo. Finally, galcanezumab improved the VM-PATHI score by 14.8