Lasmiditan and Different Triptans in Menstrual Migraine: A Bayesian Network Meta-analysis

Area of Science:

• Neurology
• Pharmacology
• Clinical Trials

Background:

• Menstrual migraine (MM) significantly impacts women's quality of life.
• Current treatments for MM lack definitive evidence of superior efficacy.
• Identifying effective MM therapies is crucial for patient well-being.

Purpose of the Study:

• To compare the efficacy and safety of various drugs for menstrual migraine (MM).
• To conduct a network meta-analysis of randomized controlled trials (RCTs) for MM treatments.
• To evaluate treatments based on sustained pain freedom, 2-hour pain-free rates, and pain relief.

Main Methods:

• Systematic search of PubMed, Embase, and Cochrane Library for RCTs up to December 2023.
• Construction of a Bayesian network meta-analysis model to synthesize evidence.
• Analysis of odds ratios (OR) and 95% confidence intervals (CI) for treatment comparisons.

Main Results:

• Lasmiditan demonstrated a significantly higher rate of sustained freedom from pain compared to placebo (OR, 14; 95% CI 3.1-100).
• No significant differences were observed between lasmiditan and triptans for 2-hour pain-free or pain relief rates.
• Rizatriptan showed a statistically significant higher probability of adverse events compared to placebo (OR, 2.7; 95% CI 1.1-7.3).

Conclusions:

• Lasmiditan is comparable to or better than some triptans for sustained pain freedom in MM treatment.
• Lasmiditan presents a promising emerging therapeutic option for managing menstrual migraine.
• Further safety analyses are required for lasmiditan due to limited data.