Real-world effectiveness and safety of lasmiditan in patients with migraine: an observational study

Objective To evaluate the real-world effectiveness and safety of lasmiditan and determine the factors associated with its effectiveness and adverse effects. Methods We evaluated 75 migraine patients (15 males and 60 females; age 44.0 ± 12.4 years), including 20 (35.1%) with chronic migraine, who completed a questionnaire in a single-center setting. Headache severity before and after taking lasmiditan was scored using a numerical rating scale (NRS), and changes in pain and most bothersome symptoms (MBS) were assessed over time. Adverse effects such as drowsiness, weakness, and dizziness, as well as preferences, were also evaluated. Results The response rate was 76% (57/75 patients, 180 attacks). Headache improvement was observed in 61.3% (100/144 attacks) at 2 h and 73.0% (119/151 attacks) at 24 h, with headache resolution rates of 27.8% (50/144 attacks) and 43.9% (71/151 attacks), respectively. Compared with patients who did not receive anti-CGRP monoclonal antibodies, patients who received anti-CGRP monoclonal antibodies had higher 2-h headache improvement rates (77.0% vs. 57.9%, p = 0.015). MBS improved by 56.9% at 60 min and 70.8% at 24 h. Adverse effects occurred in 81.3% of the patients, most commonly somnolence (39.4%), followed by weakness (32.2%) and dizziness (19.4%). Patients without somnolence had higher 24-h headache improvement rates than those with somnolence did (78.3% vs. 52.9%, p < 0.001). Despite frequent adverse effects, 25% of patients (19/75) used lasmiditan as their sole treatment for acute attacks. Conclusion Lasmiditan demonstrated meaningful effectiveness in a real-world setting, although adverse effects were common.