Long-term treatment with lasmiditan in patients with migraine: Results from the open-label extension of the CENTURION randomized trial

BACKGROUND

Following the CENTURION phase 3 randomized controlled trial's four-month double-blind phase, this 12-month open-label extension collected data for up to one year about dose optimization, patterns of use, migraine-related disability, and quality of life during lasmiditan treatment.

METHODS

Migraine patients ≥18 years completing the double-blind phase and treating ≥3 migraine attacks could continue into the 12-month open-label extension. The initial oral lasmiditan dose was 100 mg; the dose could subsequently be adjusted to 50 mg or 200 mg at the investigator's discretion.

RESULTS

477 patients entered and 321 (72.1%) completed the extension; 445 (93.3%) treated ≥1 attack with lasmiditan. Of 11,327 attacks, 8654 (76.4%) were lasmiditan-treated (84.9% of these involved moderate or severe pain). By study end, 17.8%, 58.7%, and 23.4% of patients were taking lasmiditan 50, 100, and 200 mg, respectively. Mean improvements were observed in disability and quality of life. The most common treatment-emergent adverse event was dizziness (35.7% of patients, 9.5% of attacks).

CONCLUSIONS

During this 12-month extension, lasmiditan was associated with a high rate of study completion, most attacks were treated with lasmiditan, and patients reported improvements in migraine-related disability and quality of life. No new safety findings were observed with longer exposure.Trial registration: ClinicalTrials.gov (NCT03670810); European Union Drug Regulating Authorities Clinical Trials Database (EUDRA CT: 2018-001661-17).

A pilot exploratory study comparing the King-Devick test (KDT) during and between migraine attacks

BACKGROUND

The King-Devick test is a timed rapid number naming task that involves complex cerebral functions. The objective of this pilot exploratory study is to determine whether there is a difference in the King-Devick test during a migraine attack compared to the interictal phase.

METHODS

We evaluated 29 adult subjects with migraine with aura or migraine without aura. For each participant, we performed King-Devick tests during migraine attacks and interictal phases. Subjects served as their own controls.

RESULTS

The King-Devick test was slower during the migraine attack compared to the interictal baseline (median 4.6 sec slower, p < 0.001). The slowing of the King-Devick test during migraine attack was more prominent in those with migraine with aura compared to subjects with migraine without aura (median 7.5 vs. 2.8 sec, p = 0.028).

CONCLUSIONS

This exploratory, observational study shows changes in the King-Devick test during migraine compared to the interictal phase. Future studies are required to determine if the King-Devick test may be used as a rapid and simple tool to objectively characterize migraine-associated disability.

An Assessment of the Dietary Habits of Individuals with Migraine Living in Spain: An Exploratory Observational Cross-Sectional Pilot Study

BACKGROUND/OBJECTIVES

Eating habits have been proposed as a potential therapeutic approach for migraines; nevertheless, scientific evidence to support firm recommendations is lacking. Specifically, dietary habits in migraineurs living in Spain have not been investigated. Therefore, this study aimed to evaluate their dietary patterns and examine how these habits vary based on the frequency of migraine attacks or the degree of migraine-related disability.

METHODS

An exploratory, observational, cross-sectional pilot study was conducted on 260 individuals (18-64 years old) diagnosed with migraine in Spain. Data on diet, lifestyle, and migraine characteristics were collected with an online questionnaire consisting of a food frequency questionnaire and enquires about perceptions about diet, lifestyle, and different aspects related to migraines. Statistical differences were analyzed with the Kruskal-Wallis test, followed by Dunn's post-hoc test, using JASP.

RESULTS

The consumption of plant-based foods was below the AESAN recommendations. No differences were observed in terms of food servings consumption across different migraine attack frequencies or levels of migraine-related disability. Both the chronic migraine group and the severe disability group showed differences in the consumption of some foods considered as migraine triggers (such as chocolate, cured cheese, cured meats, and alcoholic beverages). Moreover, people who suffered from infrequent migraine consumed significantly more caffeine than those who had chronic migraine.

CONCLUSION

It remains unclear whether avoiding dietary migraine triggers is driven by the biological effects of certain food compounds or influenced by dietary perceptions and unfounded beliefs. Thus, further research on the role of diet in migraine management is necessary.