Headache Medicine 2020, 11(3):78 ISSN 2178-7468, e-ISSN 2763-6178

ASAA

DOI: 10.48208/HeadacheMed.2020.22

Headache Medicine

Commentary

Lasmiditan for the acute treatment of migraine: Subgroup analyses

by prior response to triptans

Fabíola Dach Éckeli

Faculdade de Medicina de Ribeirão Preto, USP, Ribeirão Preto, São Paulo, Brazil

The use of Lasmiditan, a highly selective agonist for the 5-HT1F receptor with penetration into the central

nervous system, had its effectiveness proven for the acute treatment of migraine in two phase 3 studies,

called SAMURAI and SPARTAN. In both studies, the percentage of patients who were pain-free after 2

h in lasmiditan groups was higher than in the placebo group.

2,3

Bearing in mind that lasmiditan and tryptans are different in structure and pharmacologically, the study

in question aimed to investigate the response of lasmiditan for the acute treatment of migraine in relation

to the previous response to tryptans (good or insufcient) and in those who never use this class of drug,

based on the SAMURAI and SPARTAN studies.

Regarding the response to the acute treatment of migraine with lasmiditan in those who have already

used triptan, lasmiditan proved to be effective both in those with good response to triptan and in those

with insufcient response in the following outcomes: pain-free in 2 h, absence of most uncomfortable

symptoms in 2 hours and pain relief in 2 hours. The benet was greater than placebo at all doses tested

(50, 100 and 200 mg lasmiditan).

In those, who never used triptans, lasmiditan was effective in the acute treatment of migraine in doses

of 100 and 200 mg when compared with placebo for the same outcomes reported above. Taking into

account that lasmiditan has no vasoconstrictor effects in animal models and in human, the results of the

current study suggest that lasmiditan, the rst tested drug of the new therapeutic class called “ditan”, is

a therapeutic option for patients with or without previous experience with triptans, as well as those with

contraindications to that class of medication.

Fabíola Dach Éckeli

https://orcid.org/0000-0003-4249-4179

Reference

1. Knievel K, Buchanan AS, Lombard L, et al. Lasmiditan for the acute treatment of migraine: Subgroup anal-

yses by prior response to triptans.

Cephalalgia

2020; 40(1):19-27. doi: 10.1177/0333102419889350.

2. Kuca B, Silberstein SD, Wietecha L, et al. COL MIG-301 Study Group. Lasmiditan is an effective

acute treatment for migraine: A phase 3 randomized study.

Neurology

2018; 91:e2222–e2232.

3. Goadsby PJ, Wietecha LA, Dennehy EB, et al. Phase 3 randomized, placebocontrolled, double-blind

study of lasmiditan for acute treatment of migraine.

Brain

2019; 142:1894–1904.

fabioladach@usp.br

Received: September 15, 2020

Accepted: September 19, 2020

Edited by

Marcelo Moraes Valença