Abstract Details

Title The Effect of Lacosamide on Chronic Migraine: Retrospective Analysis in a Single Center Healthcare Academic Institute

Topic Headache

Presentation(s) P3 - Poster Session 3 (5:30 PM-6:30 PM)

Poster/Presentation
Number 13-023

Objective

To assess the effectiveness of lacosamide on migraine outcomes in a single center healthcare academic institute.

Background Antibodies targeting calcitonin gene-related peptide (CGRP) or its receptor are effective in chronic migraine therapy. Lacosamide is an antiepileptic drug that blocks CGRP release in the trigeminal system by inhibiting collapsin response mediator protein 2 (CRMP2) phosphorylation. Animal studies have demonstrated the potential efficacy of lacosamide in acute migraine therapy, though clinical investigation has yet to be initiated.

Design/Methods

We identified and characterized a cohort of patients including those administered lacosamide from January 2012 to October 2018 at the University of Utah Headache clinic and possessing an ICD-10 diagnosis of migraine (G43). As a preliminary case series, we performed a retrospective chart review of 6 patients in this cohort who were prescribed lacosamide by our physician. All 6 patients were diagnosed with chronic migraine according to ICHD3-beta criteria.

Results Of the 6 patients, the average age was 33.83 (range was 18 to 62), with 67% female (n = 4). We observed a mean reduction of Migraine Disability Assessment (MIDAS) scores by 36.17, headache frequency by 9.83 days, and pain levels associated with headaches by 1.17 following administration of lacosamide. Medications discontinued prior to lacosamide include antidepressants such as SNRIs (venlafaxine) and TCAs (nortriptyline), other anticonvulsant drugs (phenytoin ER), and NSAIDs (indomethacin, naproxen).

Conclusions

This is the first retrospective examination of the efficacy of lacosamide on clinically-assessed migraine outcomes, demonstrating potential for the drug to be used as an effective therapy for patients with chronic migraine. We plan to perform further chart review for the larger cohort of patients at our clinic and determine whether lacosamide is correlated with improved migraine outcomes.

Authors/Disclosures
Heidi Yuan (University of Utah) PRESENTER	No disclosure on file
Ka-Ho Wong (U of U Neurology Clinic)	The institution of Mr. Wong has received research support from The Sumaira Foundation . The institution of Mr. Wong has received research support from The Siegel Rare Neuroimmune Association.
	No disclosure on file
Seniha N. Ozudogru, MD (University of Pennsylvania)	Dr. Ozudogru has nothing to disclose.

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