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拉米地坦治疗后的功能改善:3期研究数据的事后分析

Improvement in Function after Lasmiditan Treatment: Post Hoc Analysis of Data from Phase 3 Studies.

作者信息

Smith Timothy, Krege John H, Rathmann Suchitrita S, Dowsett Sherie A, Hake Ann, Nery Emel S M, Matthews Brandy R, Doty Erin G

机构信息

StudyMetrix Research, St. Peters, MO, USA.

Eli Lilly and Company, Indianapolis, IN, USA.

出版信息

Neurol Ther. 2020 Dec;9(2):459-471. doi: 10.1007/s40120-020-00185-5. Epub 2020 May 23.

Abstract

INTRODUCTION

Migraine is associated with substantial functional impairment and affects many aspects of daily life.

METHODS

Using data from SAMURAI and SPARTAN (double-blind, placebo-controlled, phase 3 studies) and GLADIATOR (an open-label, phase 3 study enrolling patients who had completed SAMURAI or SPARTAN), we assessed the effects of lasmiditan on migraine-related functional disability at multiple time points from 0.5 to 48 h post dose by asking patients to rate how much the migraine was interfering with normal activities. Pooled data from SAMURAI and SPARTAN (SAMURAI + SPARTAN) and data from GLADIATOR were analyzed using the intention-to-treat populations.

RESULTS

For SPARTAN + SAMURAI, significantly more patients who received lasmiditan at any dose versus placebo reported freedom from migraine-related functional disability at every timepoint from 2 h post dose, and this difference persisted to 48 h (p < 0.05). Significant differences from placebo in freedom from migraine-related functional disability commenced at 1 h post dose for lasmiditan 200 mg, 1.5 h for lasmiditan 100 mg, and 2 h for lasmiditan 50 mg. Findings from GLADIATOR supported those from SAMURAI + SPARTAN.

CONCLUSION

All doses of lasmiditan resulted in an improvement in migraine-related functional disability that persisted to 48 h. In SAMURAI + SPARTAN, a significant difference from placebo was observed as early as 1 h post dose. TRIAL REGISTRATION AT CLINICALTRIALS.GOV: SAMURAI (NCT02439320), SPARTAN (NCT02605174), and GLADIATOR (NCT02565186).

摘要

引言

偏头痛与严重的功能障碍相关,会影响日常生活的许多方面。

方法

利用来自SAMURAI和SPARTAN(双盲、安慰剂对照的3期研究)以及GLADIATOR(一项开放标签的3期研究,纳入完成SAMURAI或SPARTAN的患者)的数据,我们通过让患者对偏头痛干扰正常活动的程度进行评分,在给药后0.5至48小时的多个时间点评估了拉米地坦对偏头痛相关功能残疾 的影响。使用意向性治疗人群分析了来自SAMURAI和SPARTAN的汇总数据(SAMURAI + SPARTAN)以及来自GLADIATOR的数据。

结果

对于SPARTAN + SAMURAI,与安慰剂相比,任何剂量接受拉米地坦治疗的患者在给药后2小时的每个时间点报告无偏头痛相关功能残疾的比例均显著更高,且这种差异持续至48小时(p < 0.05)。拉米地坦200mg在给药后1小时、100mg在给药后1.5小时、50mg在给药后2小时与安慰剂相比,在无偏头痛相关功能残疾方面开始出现显著差异。GLADIATOR的研究结果支持了SAMURAI + SPARTAN的结果。

结论

所有剂量的拉米地坦均能改善偏头痛相关功能残疾,且持续至48小时。在SAMURAI + SPARTAN中,给药后1小时就观察到与安慰剂的显著差异。临床试验注册于ClinicalTrials.gov:SAMURAI(NCT02439320)、SPARTAN(NCT02605174)和GLADIATOR(NCT02565186)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fd33/7606429/43b403720b96/40120_2020_185_Fig1_HTML.jpg

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