Abstract Details

Title Response to Lasmiditan for Acute Treatment of Migraine Based on Prior Response to Triptan Therapy

Topic Headache

Presentation(s) P4 - Poster Session 4 (5:30 PM-6:30 PM)

Poster/Presentation
Number 13-022

Objective This post-hoc analysis determined whether response to lasmiditan differed by prior triptan therapy response in participants of SAMURAI and SPARTAN (pooled data).

Background Lasmiditan is a novel, 5-HT_1F receptor agonist. In two Phase 3 studies, SAMURAI and SPARTAN, the percentage of patients (MIDAS score ≥11) who were migraine pain-free 2 hours post-first dose was greater with lasmiditan 200mg and 100mg vs placebo (p<0.001).

Design/Methods Data from participants reporting triptan use within 3 months prior to screening and randomized to receive lasmiditan 100mg or 200mg, or placebo, as first dose, were analyzed. At baseline, participants rated themselves as good, poor or non responders to prior triptan therapy. To determine whether therapeutic benefit varied according to prior triptan response, treatment-by-subgroup analyses of 2-hr outcomes used a logistic regression model, including study, treatment, rescue medication use and triptan responder subgroup (good vs poor/non responder). Significance for interaction was defined as p<0.1.

Results There was no evidence that lasmiditan 200mg benefit (on headache pain freedom, most bothersome symptom [MBS] freedom, headache pain relief) differed significantly between triptan responder subgroups. A significant differential benefit of lasmiditan 100mg vs placebo favoring poor/non responders vs good responders was seen for headache pain freedom (odds ratio [OR] 4.5 vs 1.8, p=0.056) and MBS freedom (OR 3.2 vs 1.5, p=0.042). Risk relative to placebo of experiencing a treatment-emergent adverse event was significantly lower for poor/non responders vs good responders for each lasmiditan dose.

Conclusions Lasmiditan is a possible alternative migraine therapy option for patients regardless of prior response to triptans.

Authors/Disclosures
Kerry L. Knievel, DO (Barrow Neurological Institute) PRESENTER	Dr. Knievel has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Abbvie . Dr. Knievel has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Biohaven . Dr. Knievel has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Lundbeck . Dr. Knievel has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Lilly. Dr. Knievel has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Pfizer. Dr. Knievel 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. Knievel has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for AbbVie . Dr. Knievel has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Amgen . Dr. Knievel has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Biohaven . Dr. Knievel has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Lundbeck . Dr. Knievel has received personal compensation in the range of $10,000-$49,999 for serving as an officer or member of the Board of Directors for Headache Cooperative of the Pacific . The institution of Dr. Knievel has received research support from Abbvie .
Louise Lombard	Louise Lombard has received personal compensation for serving as an employee of Eli Lilly.
Andrew Buchanan	No disclosure on file
	No disclosure on file
Joel Raskin	No disclosure on file
Joshua Tobin, MD, FAAN (Banner University Medical Center Neurosciences Institute)	An immediate family member of Dr. Tobin has received personal compensation for serving as an employee of Amgen. Dr. Tobin has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Eli Lilly. Dr. Tobin has received personal compensation in the range of $50,000-$99,999 for serving on a Speakers Bureau for AbbVie.

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