Hartford HealthCare, Neurology Department, University of Connecticut, Milford, CT, USA.
Department of Neurology, Keio University School of Medicine, Tokyo, Japan.
Cephalalgia. 2023 Feb;43(2):3331024221137092. doi: 10.1177/03331024221137092.
Long-term data helps assess the consistency of efficacy, tolerability, and safety of acute treatment over repeated use for different attacks. Real-world studies help assess tolerability, safety, and efficacy in patients with possibly refractory chronic migraine, more comorbidities, other diseases such as cardiovascular diseases, and polypharmacy.
This is a narrative review of the long-term open-label and real-world studies of lasmiditan, ubrogepant, and rimegepant for the acute treatment of migraine. Both manuscripts and abstracts were reviewed.
The efficacy and tolerability of lasmiditan, ubrogepant, and rimegepant are maintained over time. No significant cardiovascular adverse events were thought to be related to any of these medications. The rare instances of palpitations and/or tachycardia occurred within 48 hours of lasmiditan. One participant with a history of supraventricular tachycardia had sinus tachycardia thought to be related to ubrogepant which did not recur despite continued use. One case of thrombocytopenia and two cases of increased aspartate aminotransferase and alanine transaminase were thought to be possibly related, but the alanine transaminase and aspartate aminotransferase levels normalized despite continued use of ubrogepant. A case of first-degree atrioventricular block was considered possibly related to rimegepant. Acute use of rimegepant was associated with a decrease in monthly migraine days over time. The three medications were associated with improvement in function and/or productivity.
Long-term and real-world data of tolerability, safety and efficacy of lasmiditan, ubrogepant, and rimegepant is thus far consistent with prior studies, but more longitudinal data that clarifies long-term safety as well as consistency and predictors of response is needed.
长期数据有助于评估不同发作时重复使用急性治疗的疗效、耐受性和安全性的一致性。真实世界的研究有助于评估可能难治性慢性偏头痛、更多合并症、其他疾病（如心血管疾病）和多种药物治疗的患者的耐受性、安全性和疗效。
这是一篇关于 lasmiditan、ubrogepant 和rimegepant 用于偏头痛急性治疗的长期开放标签和真实世界研究的叙述性综述。对全文和摘要进行了审查。
lasmiditan、ubrogepant 和 rimegepant 的疗效和耐受性随时间保持不变。没有认为与这些药物有关的重大心血管不良事件。少数心动过速和/或心动过速发生在 lasmiditan 后 48 小时内。一名有室上性心动过速病史的患者出现窦性心动过速，认为与 ubrogepant 有关，但尽管继续使用，但未再发生。一例血小板减少症和两例天冬氨酸氨基转移酶和丙氨酸氨基转移酶升高被认为可能与 ubrogepant 有关，但丙氨酸氨基转移酶和天冬氨酸氨基转移酶水平在继续使用 ubrogepant 后恢复正常。一度房室传导阻滞被认为可能与 rimegepant 有关。rimegepant 的急性使用随时间推移导致每月偏头痛天数减少。这三种药物均能改善功能和/或生产力。
迄今为止，lasmiditan、ubrogepant 和 rimegepant 的耐受性、安全性和疗效的长期和真实世界数据与先前的研究一致，但需要更多的纵向数据来阐明长期安全性以及一致性和反应预测因素。
