Lasmiditan for the treatment of acute migraine: a review and potential role in clinical practice

Oswald, Jessica; Schuster, Nathaniel M.

doi:10.2147/jpr.s152216

Cited by 34 publications

(21 citation statements)

References 31 publications

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“…Lasmiditan is a 5-HT 1F receptor agonist [19] which is administrated orally in 50–200 mg doses and it has a t max of 1.5–2.5 h [20]. Of the three phase III clinical trials (SAMURAI, NCT02439320 [21]; SPARTAN, NCT02605174 [22]; GLADIATOR, NCT02565186 [23]), to date only one (SAMURAI [24]) has been published [24].…”

Section: Introductionmentioning

confidence: 99%

Therapeutic novelties in migraine: new drugs, new hope?

2019

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BackgroundIn the past decade, migraine research has identified novel drug targets. In this review, we discuss recent data on emerging anti-migraine therapies.Main bodyThe development of ditans, gepants and anti-calcitonin gene-related peptide monoclonal antibodies for the treatment of migraine is one of the greatest advances in the migraine field. Lasmiditan, rimegepant and ubrogepant will extend our therapeutic armamentarium for managing acute migraine attacks when triptans are not effective or contraindicated due to cardiovascular disorders. The monoclonal antibodies are migraine specific prophylactic drugs with high responder rates and favorable adverse event profiles. Furthermore, they offer convenient treatment regimens of 4- or 12-week intervals.ConclusionCollectively, novel migraine therapies represent a major progress in migraine treatment and will undoubtedly transform headache medicine.

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Section: Introductionmentioning

confidence: 99%

Therapeutic novelties in migraine: new drugs, new hope?

2019

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“…Differently from triptans, that bind to the 5HT 1B e 5HT 1D receptors, they do not induce peripheral vasoconstriction despite having a similar therapeutic efficacy on the migraine. So, they are better tolerated and with less contraindications related to the peripheral vasoconstriction [58]. The most used today is Lasmiditan, that was shown to be efficacious and well tolerated in the treatment of acute migraine in patients with a high level of cardiovascular risk factors [59].…”

Section: Introductionmentioning

confidence: 99%

Optimising migraine treatment: from drug-drug interactions to personalized medicine

et al. 2019

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Migraine is the most disabling and expensive chronic disorders, the etiology of which is still not fully known. The neuronal systems, (glutammatergic, dopaminergic, serotoninergic and GABA-ergic) whose functionality is partly attributable to genetically determined factors, has been suggested to play an important role. The treatment of acute attacks and the prophylactic management of chronic forms include the use of different category of drugs, and it is demonstrated that not each subject has the same clinical answer to them. The reason of this is to be searched in different functional capacity and quantity of phase I enzymes (such as different isoforms of CYP P450), phase II enzymes (such as UDP-glucuronosyltransferases), receptors (such as OPRM1 for opioids) and transporters (such as ABCB1) involved in the metabolic destiny of each drug, all of these dictated by DNA and RNA variations. The general picture is further exacerbated by the need for polytherapies, often also to treat comorbidities, which may interfere with the pharmacological action of anti-migraine drugs. Personalized medicine has the objective of setting the optimal therapies in the light of the functional biochemical asset and of the comorbidities of the individual patient, in order to obtain the best clinical response. Novel therapeutic perspectives in migraine includes biotechnological drugs directed against molecules (such as CGRP and its receptor) that cause vasodilatation at the peripheral level of the meningeal blood vessels and reflex stimulation of the parasympathetic system. Drug-drug interactions and the possible competitive metabolic destiny should be studied by the application of pharmacogenomics in large scale. Drug-drug interactions and their possible competitive metabolic destiny should be studied by the application of pharmacogenomics in large scale.

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“…9 In animal studies, lasmiditan inhibited dural plasma protein extravasation and reduced the expression of c-Fos in the trigeminal nucleus caudalis following trigeminal stimulation. 11 Lasmiditan has no vasoconstrictor effect on the rabbit saphenous vein. 11 Lasmiditan has no vasoconstrictor effect on the rabbit saphenous vein.…”

Section: -Ht 1f Receptor Agonists (Ditans)mentioning

confidence: 98%

“…10 C-fos is a protein that is used as an indicator of the level of neuronal activation. 11 Lasmiditan has no vasoconstrictor effect on the rabbit saphenous vein. 10 The phase 3 SAMURAI study evaluated lasmiditan for the acute treatment of migraine.…”

Section: -Ht 1f Receptor Agonists (Ditans)mentioning

confidence: 98%

Novel Medications for the Treatment of Migraine

2019

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Objective To describe the new classes of medication for headache management and their roles in clinical practice. Background Calcitonin gene‐related peptide (CGRP) is a key component in the underlying pathophysiology of migraine. Research focused on targeting CGRP for headache treatment has led to the development of entirely new classes of medications – the gepants and the CGRP monoclonal antibodies (mAbs) – for both acute and preventive treatment. A third class, the ditans, is being developed to target the 5‐HT1F receptor to provide acute treatment without vasoconstrictive effects. Methods This article reviews the pathophysiology of migraine that has led to these new pharmacologic developments. Available information from randomized controlled trials, abstracts, press releases, and relevant preclinical studies is summarized for each class of medications. Results At the time of this writing, one ditan has been submitted to the U.S. Food and Drug Administration (FDA) for approval. One gepant is anticipated to be submitted within the first quarter of 2019, and others are in clinical trials. Three CGRP mAbs have been FDA approved and are now available in clinical practice, and a fourth was submitted in the first quarter of 2019. Conclusions The development of new migraine‐specific classes of medications provides more treatment options for both acute and preventive treatment of migraine.

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Lasmiditan for the treatment of acute migraine: a review and potential role in clinical practice

Cited by 34 publications

References 31 publications

Therapeutic novelties in migraine: new drugs, new hope?

Therapeutic novelties in migraine: new drugs, new hope?

Optimising migraine treatment: from drug-drug interactions to personalized medicine

Novel Medications for the Treatment of Migraine

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