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Lasmiditan: rapid onset of efficacy in acute migraine

AAN 2019
Lasmiditan is a novel selective 5-HT1F receptor agonist that lacks vasoconstrictive activity. Patients treated for a single migraine attack reported earlier onset of efficacy with oral lasmiditan compared to placebo. Some of the efficacy measures improved as early as 30 minutes after active treatment [1]. This was concluded from an analysis of two placebo-controlled phase 3 trials: SPARTAN and SAMURAI.

In both studies, lasmiditan met co-primary and secondary efficacy endpoints at 2 hours following initial dose. The goal of the integrated analysis was to evaluate onset of the following efficacy measures: pain freedom, total migraine freedom, most bothersome symptom freedom, pain relief, freedom from associated individual symptoms (photophobia, phonophobia, or nausea), and patient-reported ‚Äėno disability‚Äô due to migraine. From 60 minutes onwards, rates of pain freedom and total migraine freedom were significantly higher in lasmiditan 100 and 200 mg groups compared with placebo (P<0.01). In the same groups, rates of patients who were photophobia-free, most bothersome symptom-free, and experienced pain relief were significantly higher starting 30 minutes post-dose, (P<0.05). In the 200 mg group, significantly more patients were phonophobia-free at 30 minutes post-dose (P<0.05) and reported ‚Äúno disability‚ÄĚ due to migraine at 60 minutes (P=0.001).

1. Ashina M, et al. AAN 2019, S17.007.

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