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Monotherapy with triptans in acute migraine is ineffective in many patients and contraindicated in certain cardiovascular diseases where alternative therapeutic options are necessary to explore. This meta‐analysis has evaluated the efficacy and safety of lasmiditan for the treatment of acute migraine in adults. After performing a literature search on MEDLINE/PubMed, Scopus, Cochrane databases, and International Clinical Trial Registry Platform, reviewers assessed eligibility and extracted data from 4 relevant articles. Preferred Reporting Items for Systematic Reviews and Meta‐Analysis guidelines were followed in the selection, analysis, and reporting of findings. A random‐effects model was used to estimate effect size. Quality assessment was done using the risk of bias assessment tool and meta‐regression for probable variables affecting effect size. Subgroup analysis was done depending on the dose of lasmiditan. Lasmiditan use was associated with a significantly higher percentage of patients with pain freedom (odds ratio [OR], 2.02; 95% confidence interval [CI], 1.72‐2.39; P < .00001), sustained pain freedom (OR, 1.93; 95%CI, 1.55‐2.39; P <.00001), headache response (OR, 2.05; 95%CI, 1.77‐2.36; P < .00001), clinical disability level (OR, 1.36; 95%CI, 1.20‐1.55; P < .00001), patients’ global impression (OR, 1.88; 95%CI, 1.69‐2.10; P < .00001), and significantly lower use of rescue medication (OR, 0.49; 95%CI, 0.38‐0.63; P < .00001) compared to placebo. Lasmiditan use was also associated with a higher likelihood of adverse effects like dizziness (OR, 6.54; 95%CI, 4.24‐10.07; P < .00001), paresthesia (OR, 4.28; 95%CI, 2.97‐6.17; P < .00001), and fatigue (OR, 5.67; 95%CI, 3.78‐8.52; P < .00001) compared to placebo. Subgroup analysis showed a dose‐dependent effect of lasmiditan on pain freedom, sustained pain freedom, patient's global impression, and occurrence of adverse drug reactions. Prediction probability for effect estimate favoring placebo was calculated to be 0.0017%. Lasmiditan has shown a favorable effect in terms of efficacy and safety in the treatment of an acute attack of migraine in comparison to placebo. Further studies are needed to evaluate long‐term safety, efficacy, and use in specific subgroups of patients. PROSPERO Registration Number: CRD42020177838

BACKGROUND Sagittal alignment of the spine, pelvis, and lower extremities is essential for maintaining a stable and efficient posture and ambulation. Imbalance in any element can result in compensatory changes in the other elements. Knee flexion is a compensatory mechanism for spinopelvic sagittal alignment and is markedly affected in severe knee osteoarthritis (OA). The correction of knee flexion deformity (KFD) by total knee arthroplasty (TKA) can lead to complementary changes in the sagittal spinopelvic parameters (SSPs). AIM To determine the SSP changes in patients with knee OA, with or without KFD undergoing TKA. METHODS The study was conducted in 32 patients who underwent TKA. A neutral standing whole-spine lateral radiograph was performed before surgery and 3 mo after surgery in these patients. Subjects were divided into two groups (Group 1 obtained > 10° corrections in KFD; group B obtained < 10° correction). The pelvic tilt (PT), pelvic incidence (PI), sacral slope (SS), lumbar lordosis (LL), and sagittal vertical axis (SVA) were measured. RESULTS The median of change in PT, PI, SS, LL, and SVA was 0.20 mm, 1.00 mm, 2.20 mm, −0.40 mm, and 6.8 mm, respectively. The difference in the change in SSPs between the two groups was statistically non-significant. CONCLUSION SSPs, such as PI, PT, SS, LL, and SVA, do not change significantly following TKA in end-stage knee OA despite a significant correction (> 10°) in KFD.

Nutraceuticals like Alpha‐lipoic Acid may have potential benefits as a prophylactic agent for adolescent migraine with fewer adverse events than existing medications.The present study was conducted to evaluate the safety and efficacy of add‐on Alpha‐lipoic Acid for prophylaxis in adolescent migraine.A randomized, open‐labeled, add‐on clinical trial was conducted on 60 adolescent migraineurs who were randomized to receive flunarizine or flunarizine with an add‐on Alpha‐lipoic Acid. Clinical evaluation of the frequency and severity of migraine, responder rate, PedMIDAS scoring, serum thiol, and serum calcitonin gene‐related peptide were done both at baseline and following 12 weeks of treatment.The frequency of acute attacks of migraine decreased significantly (P = 0.001) in the test group compared to the control group. The responder rate was found to be significantly (P = 0.001) higher (80%) in the test group than in the control group (33.3%). Mean monthly migraine headache days in the test group (‐7.7; 95% CI: ‐9.1 to ‐6.3; P = 0.010) showed a significant reduction. The severity of acute migraine attacks also showed a significant reduction in the test group (P = 0.001). PedMIDAS scores showed significant improvement in the test group (P = 0.021) in comparison to the control group. Serum thiol levels were significantly increased (18; 95% CI: 13.5 to 36.1, P = 0.001) in the test group. Serum Calcitonin gene‐related peptide showed significant reduction (‐122.4; 95% CI: ‐142.3 to ‐89.0, P = 0.006) with adjunctive Alpha‐lipoic Acid therapy.Add‐on Alpha‐lipoic Acid with flunarizine as a prophylactic agent for migraine in adolescents can improve clinical outcomes by improving clinical and biochemical parameters.ClinicalTrial.gov Identifier: NCT04064814This article is protected by copyright. All rights reserved