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Review Article



Lasmiditan for the treatment of acute attack of migraine: Systematic review and meta-analysis of randomized controlled trials

Sharanabasayyaswamy Basayya Hiremath, Srinivas Lokikere Devendrappa.




Abstract

Background: Acute migraine is the most common disabling chronic neurological disorder in the world. There are a huge proportion of unmet needs in treatment efficacy and satisfaction with currently available drugs and hence need for newer agents. One such FDA-approved drug is 5-HT1F Agonist lasmiditan.

Aim and Objective: The present review and meta-analysis were conducted with the objectives to analyze and review safety and efficacy of lasmiditan.

Materials and Methods: Electronic database search in PUBMED and Cochrane Library was conducted using search terms ?Lasmiditan? OR ?5-HT1F Agonist.? Randomized or cross-over studies comparing safety and/or efficacy of oral lasmiditan versus other active treatment or placebo in adults with acute attack of migraine were included in the analysis. Incidences of ?2 h pain-free? events were the primary outcome measure while the incidences of adverse drug events and control of other migraine-associated symptoms were the secondary outcome measures compared. Inverse variance method and both random and fixed effect models were used in the analysis by RevMan 5.3 software.

Results: At 2 h, freedom from pain (odds ratio: 2.02, 95% CI: 1.76, 2.31, n = 4395), most bothersome symptom, photophobia, and phonophobia were observed at significantly highest rates in 200 mg lasmiditan group than in placebo group. In decreasing order, incidences of dizziness, fatigue, ≥1 serious adverse drug reaction, paresthesia, and somnolence were significantly higher with 200 mg lasmiditan than placebo.

Conclusion: Higher the dose of lasmiditan used, rapid and stronger is its pain aborting action. Lasmiditan has effective and sustained effect up to 48 h, and hence, there is a need to analyze its potential migraine preventive effects.

Key words: Lasmiditan; Migraine; 5-HT1F Agonist






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