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Novel synthetic treatment options for migraine.
Expert Opin Pharmacother. 2021 May; 22(7):907-922.EO

Abstract

Introduction: Migraine is one of the most common neurological disorders. Nowadays, the 5-HT1B/1D receptor agonists, namely triptans, are considered as the standard of care for migraine acute treatment. However, triptans have limitations in some patients, such as incomplete pain relief, headache recurrence, and cardiovascular contraindications. New 5-HT1F receptor agonists, namely ditans, and calcitonin gene-related peptide receptor antagonists, namely gepants, have been developed as migraine-specific treatments.Areas covered: This paper reviews the available data from RCTs to assess the clinical efficacy, safety, and tolerability profile of lasmiditan, rimegepant, and ubrogepant for the acute treatment of migraine and atogepant for the prevention of migraine.Expert opinion: Available data suggest that lasmiditan, rimegepant, and ubrogepant might not have a clinical efficacy similar to triptans. Lasmiditan did not cause the typical triptan side effects but was associated with central nervous system side effects, causing temporary driving impairment. On the contrary, the new generation of gepants showed a placebo-like tolerability profile and the absence of a specific pattern of side effects. Future studies on lasmiditan and gepants with respect to established effective comparators are mandatory to support phase III results and to help clinicians to balance the benefit/risk profiles of the various acute and preventive medications.

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Publisher Full Text (DOI)

Authors+Show Affiliations

Negro A
Department of Clinical and Molecular Medicine, Sant'Andrea University Hospital, Via di Grottarossa, Rome, Italy. Regional Referral Headache Centre, Sant'Andrea Hospital, Rome, Italy.
Martelletti P
Department of Clinical and Molecular Medicine, Sant'Andrea University Hospital, Via di Grottarossa, Rome, Italy. Regional Referral Headache Centre, Sant'Andrea Hospital, Rome, Italy.

MeSH

AnalgesicsCalcitonin Gene-Related Peptide Receptor AntagonistsHumansMigraine DisordersSerotonin 5-HT1 Receptor AgonistsTryptamines

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

33369482

Citation

Negro, Andrea, and Paolo Martelletti. "Novel Synthetic Treatment Options for Migraine." Expert Opinion On Pharmacotherapy, vol. 22, no. 7, 2021, pp. 907-922.
Negro A, Martelletti P. Novel synthetic treatment options for migraine. Expert Opin Pharmacother. 2021;22(7):907-922.
Negro, A., & Martelletti, P. (2021). Novel synthetic treatment options for migraine. Expert Opinion On Pharmacotherapy, 22(7), 907-922. https://doi.org/10.1080/14656566.2020.1862793
Negro A, Martelletti P. Novel Synthetic Treatment Options for Migraine. Expert Opin Pharmacother. 2021;22(7):907-922. PubMed PMID: 33369482.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Novel synthetic treatment options for migraine. AU - Negro,Andrea, AU - Martelletti,Paolo, Y1 - 2020/12/28/ PY - 2020/12/29/pubmed PY - 2021/5/19/medline PY - 2020/12/28/entrez KW - Acute treatment KW - atogepant KW - ditans KW - gepants KW - lasmiditan KW - preventive treatment KW - rimegepant KW - ubrogepant SP - 907 EP - 922 JF - Expert opinion on pharmacotherapy JO - Expert Opin Pharmacother VL - 22 IS - 7 N2 - Introduction: Migraine is one of the most common neurological disorders. Nowadays, the 5-HT1B/1D receptor agonists, namely triptans, are considered as the standard of care for migraine acute treatment. However, triptans have limitations in some patients, such as incomplete pain relief, headache recurrence, and cardiovascular contraindications. New 5-HT1F receptor agonists, namely ditans, and calcitonin gene-related peptide receptor antagonists, namely gepants, have been developed as migraine-specific treatments.Areas covered: This paper reviews the available data from RCTs to assess the clinical efficacy, safety, and tolerability profile of lasmiditan, rimegepant, and ubrogepant for the acute treatment of migraine and atogepant for the prevention of migraine.Expert opinion: Available data suggest that lasmiditan, rimegepant, and ubrogepant might not have a clinical efficacy similar to triptans. Lasmiditan did not cause the typical triptan side effects but was associated with central nervous system side effects, causing temporary driving impairment. On the contrary, the new generation of gepants showed a placebo-like tolerability profile and the absence of a specific pattern of side effects. Future studies on lasmiditan and gepants with respect to established effective comparators are mandatory to support phase III results and to help clinicians to balance the benefit/risk profiles of the various acute and preventive medications. SN - 1744-7666 UR - https://www.unboundmedicine.com/medline/citation/33369482/Novel_synthetic_treatment_options_for_migraine_ DB - PRIME DP - Unbound Medicine ER -