Focus of the Report: This report focuses on the efficacy and safety of the 5-hydroxytryptamine 1F (5-HT1F) receptor agonist lasmiditan (Reyvow) for acute treatment of migraines.
Technology Description: The 5-HT1F receptors are found on secondary trigeminal neurons, the trigeminal ganglion, cerebral cortex, and the cerebellum, but not on vascular structures. Lasmiditan (Reyvow) binds with high selectivity to the 5-HT1F receptor, thereby blocking activation of the trigeminal neurons and inhibiting migraine. Lasmiditan belongs to a class of drugs called neurally acting antimigraine agents (NAAMAs), or ditans, which inhibit trigeminal pathways without causing a significant vasoconstrictive effect, unlike triptans, the standard treatment for migraine. Reyvow is available in 50 milligram (mg) and 100 mg oral tablets. The recommended dose is 50 mg, 100 mg, or 200 mg, as needed.
Controversy: Lasmiditan is a new molecular entity indicated for the acute treatment of migraine headache. As a Schedule V controlled substance, there is the potential for abuse or misuse (2020 Reyvow Label). It is unknown how lasmiditan compares with other medications for acute migraine treatment.
Is lasmiditan effective for acute treatment of migraine headaches?
How does lasmiditan compare with alternative acute treatments for migraine headaches?
Is lasmiditan safe?
Have definitive patient selection criteria been identified for lasmiditan?
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