Lasmiditan may provide effective acute relief from migraine, with sustained improvements in freedom from pain, most bothersome symptoms, total migraine, and disability, according to the pooled analysis of data from 2 clinical trials published in Cephalalgia.
Researchers conducted a post hoc analysis of the data from 2 phase 3 double-blind studies (SAMURAI and SPARTAN; ClinicalTrials.gov identifiers: NCT02439320 and NCT02605174, respectively) in which the efficacy of lasmiditan for the acute treatment of migraine was examined. In both studies, patients with 3 to 8 migraines per month and a Migraine Disability Assessment Score ≥11 were randomly assigned to administer lasmiditan at 200, 100, or 50 mg (only in the SPARTAN study) or placebo within 4 hours of attack onset.
A greater percentage of patients treated with lasmiditan vs placebo reported freedom from pain at 2 hours (lasmiditan: 200 mg, 35.6%; 100 mg, 29.9%; 50 mg, 28.6%; placebo, 18.3%; P <.001 for all), at 48 hours (lasmiditan: 200 mg, 21.2%; 100 mg, 16.9%; 50 mg, 17.4%; placebo, 10.3%; P <.01 for all), and at 48 hours (lasmiditan: 200 mg, 18.4%; 100 mg, 15.2%; 50 mg, 14.9%; placebo, 9.6%; P <.05 for all).
Patients in any of the lasmiditan treatment vs placebo groups also reported greater levels of freedom from most bothersome symptom, total migraine, and disability at 24 and 48 hours. In addition, a greater percentage of patients receiving lasmiditan vs placebo reported modified sustained pain freedom (ie, freedom from pain without the use of rescue medication, and in the absence of moderate to severe headache) at 24 hours (lasmiditan: 200 mg: 27.0%, 100 mg, 21.7%; 50 mg, 21.7%; placebo, 12.9%; P <.01 for all).
Study limitations include the fact that statistical analyses of efficacy were conducted without correcting for multiplicity.
“[T]he results of these post-hoc analyses suggest that lasmiditan is effective for the acute treatment of migraine attacks with sustained efficacy on all aspects of acute migraine attacks at 24 and 48 hours,” concluded the study authors.
Doty EG, Krege JH, et al. Sustained responses to lasmiditan: results from post-hoc analyses of two phase 3 randomized clinical trials for acute treatment of migraine [published online July 3, 2019]. Cephalalgia. doi: 10.1177/0333102419859313