The following is a summary of “Long-term treatment with lasmiditan in patients with migraine: post hoc analysis of treatment patterns and outcomes from the open-label extension of the CENTURION randomized trial,” published in the March 2024 issue of Pain by Komori et al.

Researchers conducted a retrospective study examining patient characteristics and other influencing factors to understand lasmiditan use patterns and outcomes in a real-world setting.

They conducted a post hoc analysis of data from a 12-month, open-label extension (OLE) of the phase 3, double-blind, randomized, controlled CENTURION trial, assespsing lasmiditan’s efficacy and safety for acute treatment of four migraine attacks. Patients from the main study who were treated ≥ 3 attacks could enter the OLE. The initial lasmiditan dose was 100 mg, with dose adjustments to 50 or 200 mg permitted at the investigator’s discretion. They summarized patient and clinical characteristics based on dosing pattern and completion status. Safety was evaluated by AE frequency per dose.

The results showed that 445 patients underwent lasmiditan treatment for at least one migraine attack during the OLE, with 321 (72.1%) completing the study. Among them, 47% maintained the initial 100-mg dose, 20.2% used 100 mg and 50 mg, 30.6% used 100 and 200 mg, and 1.3% used multiple dose levels. All dosing patterns correlated with clinical and patient-reported improvement; notably, the 100-mg group had the highest proportion of patients reporting progress in the Patient Global Impression of Change – Migraine Headache Condition (56.5% vs. 33.4%–52.2%). Conversely, groups adjusting doses exhibited higher completion rates (72.1%–83.3% vs. 68.9%) than the 100-mg group. The frequency of AEs decreased with sustained lasmiditan use. Concurrent use of triptans with lasmiditan did not heighten AE occurrence.

Investigators concluded that the 100mg dose offered a balance of efficacy and tolerability, with dose adjustments improving outcomes and continued use linked to reduced side effects.

Source: thejournalofheadacheandpain.biomedcentral.com/articles/10.1186/s10194-024-01745-y