Lasmiditan

(Reyvow®)

Lasmiditan

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Drug updated on 5/17/2024

Dosage FormTablet (oral; 50 mg, 100 mg)
Drug ClassSerotonin (5-HT) 1F receptor agonists
Ongoing and
Completed Studies
ClinicalTrials.gov

Indication

  • Indicated for the acute treatment of migraine with or without aura in adults.

Summary
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  • Lasmiditan (Reyvow) is indicated for the acute treatment of migraine with or without aura in adults. It has demonstrated a higher probability of achieving pain freedom within 2 hours compared to Ubrogepant and Zavegepant, particularly at doses of 100 mg and 200 mg.
  • Fifteen systematic reviews/meta-analyses on the use of Reyvow (lasmiditan) for the acute treatment of migraine in adults were reviewed.
  • Compared to other drugs such as Rimegepant and Ubrogepant, Lasmiditan showed variable efficacy when compared with traditional triptans, which often displayed higher odds ratios for pain freedom at two hours.
  • However, Lasmiditan was associated with a greater risk of adverse effects, predominantly central nervous system-related events like dizziness, somnolence, fatigue, paresthesia, and nausea. This contrasted with better tolerability profiles observed from using Ubrogepant or calcitonin gene-related peptide antagonists like Rimegepant and Zavegepant that posed lower risks for these CNS effects.
  • The choice between dosages involves balancing increased efficacy against risk factors; while the higher dose consistently showed greater effectiveness in achieving pain relief but also heightened risk reactions.
  • Lasmiditan's mechanism as a serotonin receptor agonist offers a potential advantage for those having cardiovascular concerns despite its high incidence rate towards CNS-related side-effects.
  • While it is effective especially among those needing rapid relief or have cardiovascular issues, its profile necessitates careful assessment based on patient-specific factors due to its adverse effect profile requiring dose optimization based on individual response tolerance levels.
  • The comparative efficacy-safety balance offered by Lasmiditan might be preferential among certain subgroups such as those having specific cardiovascular risks, making understanding nuances crucial towards optimizing management strategies.

Product Monograph / Prescribing Information

Document TitleYearSource
Reyvow (lasmiditan) Prescribing Information.2022Lilly USA, LLC., Indianapolis, IN

Systematic Reviews / Meta-Analyses

Document TitleYearSource
Comparison of effectiveness and safety of lasmiditan and CGRP-antagonists for the acute treatment of migraine in adults: systematic review and network meta-analysis of randomised trials. 2024The Journal of Headache and Pain
Comparison of lasmiditan 200 mg versus 100 mg for migraine patients: a meta-analysis of randomized controlled studies. 2024Clinical Neuropharmacology
Exploration of lasmiditan 200 mg versus 100 mg for the treatment of migraine: a meta-analysis based on aggregate data. 2024Clinical Neuropharmacology
Efficacy, safety and indirect comparisons of lasmiditan, rimegepant, and ubrogepant for the acute treatment of migraine: a systematic review and network meta-analysis of the literature.2023Cephalalgia
Rimegepant, ubrogepant, and lasmiditan in the acute treatment of migraine examining the benefit-risk profile using number needed to treat/harm.2022The Clinical Journal of Pain
Relative efficacy of lasmiditan versus rimegepant and ubrogepant as acute treatments for migraine: network meta-analysis findings.2022The Journal of Headache and Pain
Lasmiditan abortive therapy for episodic migraine in phase II/III randomized clinical trials: a meta-analysis.2022Indian Journal of Pharmacology
Efficacy and safety of lasmiditan for acute treatment of migraine in adults: a meta-analysis.2021The Journal of Clinical Pharmacology
The effect and safety of 5-HT1F receptor agonist lasmiditan on migraine: a systematic review and meta-analysis.2021BioMed Research International
Acute treatments for episodic migraine in adults: a systematic review and meta-analysis.2021JAMA
Comparison of new pharmacologic agents with triptans for treatment of migraine: a systematic review and meta-analysis.2021JAMA
Optimal dosing of lasmiditan in the management of acute migraine attack: a systematic review and meta-analysis.2021Annals of Indian Academy of Neurology
Comparative efficacy and safety of rimegepant, ubrogepant, and lasmiditan for acute treatment of migraine: a network meta-analysis.2021Expert Review of Pharmacoeconomics & Outcomes Research
Lasmiditan for acute treatment of migraine in adults: a systematic review and meta-analysis of randomized controlled trials.2020CNS Drugs
Short-term efficacy and safety of lasmiditan, a novel 5-HT1F receptor agonist, for the acute treatment of migraine: a systematic review and meta-analysis.2020The Journal of Headache and Pain

Clinical Practice Guidelines