Lasmiditan, at higher doses, was found to be more effective than rimegepant and ubrogepant for treating acute migraine attacks, though it was linked to higher odds of adverse events, according to a study published in Cephalalgia.

To investigate the efficacy of newer migraine agents, the researchers conducted a random-effects network meta-analysis that included 7 studies involving nearly 13,000 patients. The trials included were phase 3 studies that examined lasmiditan, a serotonin (5-HT) 1F receptor agonist, and rimegepant and ubrogepant, both calcitonin gene-related peptide receptor antagonists, as acute treatments for migraine.

Findings showed that all 3 medications were superior to placebo on the coprimary endpoints of 2-hour pain freedom and freedom from the most bothersome migraine symptom (MBS) associated with migraine attack. Treatment with higher dose lasmiditan (100mg and 200mg) was found to be more effective than rimegepant (75mg) and ubrogepant (50mg or 100mg) with respect to 2-hour pain freedom, while freedom from MBS was achieved equally by all 3 interventions.

Compared with rimegepant and ubrogepant, lasmiditan was associated with greater odds of treatment-emergent adverse events including dizziness, nausea, and somnolence. Of the 3 medications, ubrogepant 50mg was ranked best for tolerability.

“Rimegepant 75mg and ubrogepant 50 and 100mg present good efficacy and a favorable tolerability profile, albeit lower odds of achieving complete pain freedom,” the authors concluded. They noted that the findings should be interpreted cautiously due to the lack of head-to-head comparisons.

Acute Treatment of Migraine: Lasmiditan, Rimegepant, Ubrogepant Compared

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