拉米地坦在偏头痛治疗中的潜力。

The potential of lasmiditan in migraine.

作者信息

Mecklenburg Jasper, Raffaelli Bianca, Neeb Lars, Sanchez Del Rio Margarita, Reuter Uwe

机构信息

Department of Neurology, Charité Universitätsmedizin Berlin, Berlin, Germany.

Neurology Department, Clinica Universidad de Navarra, Madrid, Spain.

出版信息

Ther Adv Neurol Disord. 2020 Oct 21;13:1756286420967847. doi: 10.1177/1756286420967847. eCollection 2020.

Abstract

Lasmiditan, a highly selective 5-hydroxytryptamine receptor 1F (5-HT) agonist, is the first drug in its class and is lacking triptan-like vasoactive properties. The US Food and Drug Administration (FDA) has recently approved lasmiditan for the acute treatment of migraine in adults based on positive results of two pivotal phase III trials, which showed a significant difference to placebo in the proportion of patients achieving total migraine freedom within 2 h. More patients with lasmiditan achieved headache freedom and, in addition, freedom from the most bothersome symptom, that is, photophobia, than with placebo. Treatment-related side effects seem to be related to the rapid penetration of the drug into the brain and include dizziness, paresthesia and drowsiness, mostly of mild to moderate intensity. Interim results from an ongoing long-term phase III trial suggest a decrease in the frequency of adverse events after multiple lasmiditan use. Lasmiditan is a promising acute anti-migraine therapy, in particular for patients with cardiovascular risk factors, contraindications, or unwanted side effects to triptans.

摘要

拉米地坦是一种高选择性5-羟色胺受体1F(5-HT)激动剂,是该类药物中的首个药物,不具有曲坦类药物样的血管活性特性。基于两项关键III期试验的阳性结果,美国食品药品监督管理局(FDA)最近批准拉米地坦用于成人偏头痛的急性治疗,试验表明在2小时内实现完全无偏头痛的患者比例方面,与安慰剂相比有显著差异。与安慰剂相比,更多使用拉米地坦的患者实现了头痛缓解,此外,还摆脱了最困扰的症状,即畏光。治疗相关的副作用似乎与药物快速进入大脑有关,并包括头晕、感觉异常和嗜睡,大多为轻度至中度。一项正在进行的长期III期试验的中期结果表明,多次使用拉米地坦后不良事件的频率有所降低。拉米地坦是一种有前景的急性抗偏头痛疗法,尤其适用于有心血管危险因素、禁忌证或对曲坦类药物有不良副作用的患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6f9a/7739205/93470ef2afeb/10.1177_1756286420967847-fig1.jpg

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