Lasmiditan is effective for acute treatment of episodic migraine

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Created On: 07/11/2020

Lasmiditan is effective for acute treatment of episodic migraine

A meta-analysis was conducted to investigate the safety and efficacy of lasmiditan (an orally available selective serotonin 5-HT_1F receptor agonist) in adult patients for the acute management of migraine.

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Key take away

The findings of a meta-analysis revealed that in adults with migraine, lasmiditan is effective for acute treatment. It remarkably elevates the absence of the most bothersome symptoms at two hours post-dose and freedom of pain. Lasmiditan 200 mg demonstrated superior efficacy compared to the 100-mg dose with a similar risk for developing adverse events.

Background

Method

Cochrane Library databases, EMBASE, and PUBMED were systematically explored. The suitable articles published prior to 3 March 2020 were collected. Following were the inclusion criteria (a) randomized clinical trials (b) recruited adult subjects diagnosed with migraine (c) recruited more than 100 participants (d) compared placebo with lasmiditan at 200 mg or 100 mg, and (e) offered any available data for predefined secondary or primary outcome parameters. The study included three high-quality, randomized, multi-centered trials with 4506 participants.

Result

Compared with patients in the placebo group, the use of lasmiditan was found to considerably raise the rate of pain freedom and the rate of absence of the most bothersome symptoms at two hours post-dose in, with no substantial heterogeneity, as shown below:

However, the use of lasmiditan in clinical available doses is associated with an elevated risk of developing central nervous system-related adverse events. Considering the safety endpoints, participants in the lasmiditan group had an elevated rate of fatigue, somnolence, and paresthesia in comparison with the placebo group, as shown below:

Compared to the 100 mg lasmiditan dose in a subgroup analysis, the 200 mg lasmiditan dose offered sustained pain relief at 2–24 h and freedom of pain at two hours (without safety differences) with low heterogeneity for both outcomes (I²=0%), as depicted in the following table:

Conclusion

For acute management of migraine, lasmiditan is effective for short-term use. Compared to lasmiditan 100 mg, lasmiditan 200 mg has superior efficacy and is associated with a similar risk for developing adverse events.