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Optimal dosing of lasmiditan in the management of acute migraine attack: A systematic review and meta-analysis
Annals of Indian Academy of Neurology ( IF 1.7 ) Pub Date : 2021-03-01 , DOI: 10.4103/aian.aian_1223_20
Roopa Satyanarayan Basutkar 1 , Chris Elizabeth Vinod 1 , Shruthi Jaya Saju 1 , Bhavya Chebrolu 1 , Sivasankaran Ponnusankar 1
Affiliation  


Background: The current target of migraine treatment is focused on Triptans. Lasmiditan, a non-vasoconstrictive and highly selective 5HT1F receptor agonist is a novel therapeutic discovery for migraine for patients with cardiovascular (CV) risk factors or stable cardiovascular diseases and who fail to respond to the existing treatment. Objective: To identify an optimal dosing of Lasmiditan 100 mg versus 200 mg for the treatment of acute migraine attacks in adult patients with cardiovascular risk factors. Methods: Systematic searches were run in databases such as Cochrane Central Register of Controlled Trials (CENTRAL), Scopus, Google scholar, and PUBMED. Out of 83 study records identified, two studies were included for quantitative analysis. Results: There was a significant headache pain freedom at 2 h [Odds Ratio (OR): 0.77; 95% Confidence interval (CI): 0.64–0.92] and sustained pain freedom at 24 h (OR): 0.75; 95% CI: 0.61–0.93] in patients taking Lasmiditan 200 mg compared to those taking Lasmiditan 100 mg. The results were statistically insignificant for parameters like most bothersome symptoms (MBS) free at 2 h, headache relief at 2 h, disability level at 2 h, and global impression of change at 2 h. A combined analysis of these parameters showed a remarkable difference between both the groups favoring Lasmiditan 200 mg [OR: 0.88; 95% CI: 0.81–0.95]. Conclusion: An oral dosing of Lasmiditan 200 mg is ideal for the treatment of acute migraine in adult patients with CV risk factors for attaining headache pain freedom at 2 h and sustained pain freedom at 24 compared to Lasmiditan 100 mg.


中文翻译:

Lamiditan在急性偏头痛发作治疗中的最佳剂量:系统评价和荟萃分析


背景:偏头痛的当前治疗目标集中在曲普坦类药物上。Lasmiditan是一种非血管收缩性且高度选择性的5HT 1F受体激动剂,是偏头痛的新型治疗方法,适用于患有心血管(CV)危险因素或稳定心血管疾病且对现有治疗无效的患者。目的:确定用于治疗患有心血管危险因素的成年患者急性偏头痛发作的最佳剂量的Lasmiditan与200 mg。方法:系统搜索在数据库中进行,例如Cochrane对照试验中央注册系统(CENTRAL),Scopus,Google Scholar和PUBMED。在确定的83项研究记录中,包括两项研究以进行定量分析。结果: 2 h有明显的头痛疼痛自由度[几率(OR):0.77; 95%置信区间(CI):0.64-0.92]和24小时持续疼痛自由度(OR):0.75;与服用Lasmiditan 100 mg的患者相比,服用Lasmiditan 200 mg的患者的95%CI:0.61-0.93]。结果对于诸如2小时无症状,2 h头痛缓解,2 h残疾水平以及2 h变化总体印象等参数无统计学意义。对这些参数的综合分析显示,两组之间在使用Lasmiditan 200 mg时存在显着差异[OR:0.88; 95%CI:0.81-0.95]。结论:与Lasmiditan 100 mg相比,口服Lasmiditan 200 mg的口服剂量是治疗具有CV危险因素的成年患者急性偏头痛的理想选择,这些患者具有2 h的头痛疼痛自由度和24 h的持续疼痛自由度。
更新日期:2021-04-29
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