Real-World Experience of Lasmiditan for the Acute Treatment of Migraine

We aimed to determine efficacy, safety, and predictors of response and side effects of lasmiditan in Korean patients with migraine.

We prospectively recruited patients who took lasmiditan at the Seoul National University Hospital between April 2023 and March 2024. We collected data on treatment, adverse events, and dosage adjustment profiles. Tolerability was defined as dosage maintenance or dosage increase. Logistic regression analyses were performed to identify predictors of a response to lasmiditan and adverse events.

This study included 154 patients. At visit 1, 110 (71.4%) and 44 (28.6%) patients were prescribed 50 and 100 mg of lasmiditan daily, respectively, with a treatment response observed at visit 2 in 49 (44.5%) and 20 (45.5%) patients, respectively. Adverse events were reported in 75 (48.7%) patients. Multivariate logistic analyses showed that female sex (odds ratio [OR]= 4.51, 95% confidence interval [CI]=1.43-14.19, p=0.01) and higher daily dose (100 mg vs. 50 mg: OR=2.35, 95% CI=1.14-4.83, p=0.02) were independently associated with adverse events. Dosage increase, dosage reduction, and treatment discontinuation occurred in 56 (36.4%), 17 (11.0%), and 40 (26.0%) patients, respectively. Lasmiditan was well tolerated by 97 (63.0%) patients.

This was the first real-world study of lasmiditan in Korean patients with migraine. Although administered at a low dosage, lasmiditan was effective in approximately half of the patients. Dizziness was the most common adverse event, and it occurred at a higher rate than in clinical trials.