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Abstract Details

Lasmiditan Efficacy in Mild Versus Moderate or Severe Migraine Headaches
Headache
Headache Posters (7:00 AM-5:00 PM)
112

Early treatment, when pain is mild, is recommended for acute treatment of migraine attacks. LTN, a novel, selective 5-HT1F receptor agonist, was superior to placebo in treating moderate-to-severe migraine attacks in two phase3 trials. There were few mild attacks studied in the phase3 program.

To evaluate the efficacy of lasmiditan (LTN) 100mg and 200mg in treating migraine attacks of mild versus moderate or severe pain severity.

This analysis assessed data (intent to treat) from a prospective, randomized, open-label, phase 3 study (GLADIATOR [NCT02565186]) in which patients were randomized 1:1 to LTN 100 mg or 200 mg. Efficacy measures included proportion of attacks with 2h pain freedom (PF), 2h most bothersome symptom (MBS) freedom, and 24h sustained pain freedom (SPF). The proportion of patients with PF, SPF, or MBS freedom among mild, moderate, or severe attacks was compared using Fisher’s exact test.

This analysis includes data from 1,981 patients who treated 17,878 migraine attacks. A total of 273 (1.5%), 11,644 (65.1%), and 5,948 (33.3%) attacks were treated when pain was mild, moderate, and severe, respectively. Average (mean) time from headache onset to treatment administration was 1.3h . There was a relative greater proportion of mild attacks with PF vs. moderate and severe attacks (mild:100mg/200mg: 33.6%[50/149]/54.8%[68/124]; oderate:29.7%[1,759/5,931]/36.2%[2,068/5,713]*; severe:17.9% [538/3,012]*/19.4%[571/2,936]*, *p<0.001). Similarly, a higher proportion of mild attacks with SPF and MBS freedom were observed. Overall, ≥1 treatment-emergent adverse event (TEAE) was reported in 16.8%, 14.3%, and 10.2% of mild, moderate, and severe migraine attacks, respectively. The most frequent TEAE was dizziness, irrespective of headache intensity across the attacks.

Treating migraine attacks at mild pain showed a tendency to relatively better efficacy outcomes, suggesting that earlier dosing is beneficial. Further research is needed to better understand the relationship of LTN outcomes to time of administration during migraine attacks. 
Authors/Disclosures
Maurice Borges Vincent, MD, PhD (Eli Lilly and Company)
PRESENTER
Prof. Vincent has received personal compensation for serving as an employee of Eli Lilly and Company. Prof. Vincent has stock in Eli Lilly and Company.
Mario F. P. Peres, MD Dr. Peres has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Eurofarma. Dr. Peres has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Eli Lilly. Dr. Peres has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Libbs. Dr. Peres has received research support from CNPq. Dr. Peres has received research support from Allergan.
Raghavendra Vasudeva, PhD Dr. Vasudeva has received personal compensation for serving as an employee of Lilly. Dr. Vasudeva has received stock or an ownership interest from Lilly.
Simin Baygani Simin Baygani has received personal compensation for serving as an employee of Eil Lilly & Company. Simin Baygani has received stock or an ownership interest from Eli Lilly & Company.
Ellen Dennehy (Eli Lilly) Ellen Dennehy has received personal compensation for serving as an employee of Eli Lilly. Ellen Dennehy has stock in Eli Lilly.
Deborah I. Friedman, MD, MPH, FAAN Dr. Friedman has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Eli Lilly. Dr. Friedman has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Lundbeck. Dr. Friedman has received personal compensation in the range of $0-$499 for serving as a Consultant for Satsuma. Dr. Friedman has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Linpharma. Dr. Friedman has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Pfizer. Dr. Friedman has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Axsome. Dr. Friedman has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Lundbeck. Dr. Friedman has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Impel. Dr. Friedman has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Abbvie. Dr. Friedman has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Neurology Reviews. Dr. Friedman has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for MedLink Neurology . The institution of Dr. Friedman has received research support from Spinal CSF Leak Foundation. Dr. Friedman has a non-compensated relationship as a Program Co-Chair, Scottsdale Headache Symposium with American Headache Society that is relevant to AAN interests or activities. Dr. Friedman has a non-compensated relationship as a Medical Advisor with Spinal CSF Leak Foundation that is relevant to AAN interests or activities. Dr. Friedman has a non-compensated relationship as a Treasurer, Board of Directors with Southern Headache Society that is relevant to AAN interests or activities.