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Lasmiditan is a selective 5-HT1F receptor agonist designed to treat migraine through a neural mechanism without the vasoconstrictor activity associated with triptans. In a phase 3 randomized trial, adults treated a single moderate-to-severe migraine attack with lasmiditan 100 mg, 200 mg or placebo. Both active doses increased the proportion of patients who were pain-free at two hours and improved freedom from the most bothersome associated symptom. The study population included many participants with cardiovascular risk factors, making the non-vasoconstrictive mechanism clinically interesting. Adverse effects such as dizziness and somnolence can occur, and patients should be counselled about driving restrictions and CNS effects. For HCPs, lasmiditan is particularly relevant for patients in whom triptans are ineffective, poorly tolerated or unsuitable because of cardiovascular considerations. It should still be used within a comprehensive acute-migraine strategy that addresses overuse and the need for preventive therapy when attack frequency is high. The trial supports the growing role of mechanism-specific acute migraine treatment.
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Lasmiditan is a selective 5-HT1F receptor agonist designed to treat migraine through a neural mechanism without the vasoconstrictor activity associated with triptans. In a phase 3 randomized trial, adults treated a single moderate-to-severe migraine attack with lasmiditan 100 mg, 200 mg or placebo. Both active doses increased the proportion of patients who were pain-free at two hours and improved freedom from the most bothersome associated symptom. The study population included many participants with cardiovascular risk factors, making the non-vasoconstrictive mechanism clinically interesting. Adverse effects such as dizziness and somnolence can occur, and patients should be counselled about driving restrictions and CNS effects. For HCPs, lasmiditan is particularly relevant for patients in whom triptans are ineffective, poorly tolerated or unsuitable because of cardiovascular considerations. It should still be used within a comprehensive acute-migraine strategy that addresses overuse and the need for preventive therapy when attack frequency is high. The trial supports the growing role of mechanism-specific acute migraine treatment.
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