E-ISSN 2231-3206 | ISSN 2320-4672
 

Systematic Review

Online Publishing Date:
01 / 07 / 2022

 


Efficacy of 5-HT1F agonist versus CGRP-antagonists for treatment of acute migraine: A systematic review and network meta-analysis

Sharanabasayyaswamy Basayya Hiremath, Srinivas Devendrappa Lokikere.


Abstract
Background: Two new classes of drugs approved by USFDA for the treatment of acute migraine are non-peptide Calcitonin Gene-Related Peptide (CGRP) receptor antagonists (rimegepant and ubrogepant) and 5-HT1F receptor agonist lasmiditan. There are no clinical trials comparing these two classes of newer drugs.

Aim and Objectives: The present network meta-analysis was conducted with the objective to compare the efficacy of orally administered lasmiditan versus CGRP-receptor antagonists (rimegepant and ubrogepant) in the treatment of acute migraine.

Materials and Methods: Electronic database search in PUBMED and Cochrane library was conducted using MeSH search terms “Lasmiditan” AND “Migraine” for articles on lasmiditan; while MeSH terms “Ubrogepant” AND “Migraine;” “Rimegeapnt” AND “Migraine” were used for articles on CGRP-antagonists. Randomized or cross-over studies comparing efficacy of oral lasmiditan and two FDA approved CGRP-antagonists (rimegepant, and ubrogepant) versus other active treatment or placebo in adults with acute attack of migraine were included in the analysis. Incidence of 2 h pain-free event was the primary outcome measure while the incidence of 24 h pain-free was the secondary outcome measure compared. Both frequent and Bayesian network meta-analysis were conducted by CRSU MetaInsight software.

Results: In 12 eligible studies, seven interventions were compared with total 13795 patients analyzed in the network. Higher treatment ranking for 2 h and 24 h pain-free events was observed for lasmiditan 200 mg and rimegepant 150 mg, respectively.

Conclusions: There is strong evidence to conclude that lasmiditan at 200 mg is better drug for immediate (2 h) headache freedom. There is limited evidence to support rimegepant for sustained effect (beyond 24 h).

Key words: Lasmiditan; CGRP-antagonists; Migraine Disorders


 
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How to Cite this Article
Pubmed Style

Hiremath SB, Lokikere SD. Efficacy of 5-HT1F agonist versus CGRP-antagonists for treatment of acute migraine: A systematic review and network meta-analysis. Natl J Physiol Pharm Pharmacol. 2023; 13(2): 224-233. doi:10.5455/njppp.2023.13.062861202220062022


Web Style

Hiremath SB, Lokikere SD. Efficacy of 5-HT1F agonist versus CGRP-antagonists for treatment of acute migraine: A systematic review and network meta-analysis. https://www.njppp.com/?mno=57906 [Access: March 14, 2024]. doi:10.5455/njppp.2023.13.062861202220062022


AMA (American Medical Association) Style

Hiremath SB, Lokikere SD. Efficacy of 5-HT1F agonist versus CGRP-antagonists for treatment of acute migraine: A systematic review and network meta-analysis. Natl J Physiol Pharm Pharmacol. 2023; 13(2): 224-233. doi:10.5455/njppp.2023.13.062861202220062022



Vancouver/ICMJE Style

Hiremath SB, Lokikere SD. Efficacy of 5-HT1F agonist versus CGRP-antagonists for treatment of acute migraine: A systematic review and network meta-analysis. Natl J Physiol Pharm Pharmacol. (2023), [cited March 14, 2024]; 13(2): 224-233. doi:10.5455/njppp.2023.13.062861202220062022



Harvard Style

Hiremath, S. B. & Lokikere, . S. D. (2023) Efficacy of 5-HT1F agonist versus CGRP-antagonists for treatment of acute migraine: A systematic review and network meta-analysis. Natl J Physiol Pharm Pharmacol, 13 (2), 224-233. doi:10.5455/njppp.2023.13.062861202220062022



Turabian Style

Hiremath, Sharanabasayyaswamy Basayya, and Srinivas Devendrappa Lokikere. 2023. Efficacy of 5-HT1F agonist versus CGRP-antagonists for treatment of acute migraine: A systematic review and network meta-analysis. National Journal of Physiology, Pharmacy and Pharmacology, 13 (2), 224-233. doi:10.5455/njppp.2023.13.062861202220062022



Chicago Style

Hiremath, Sharanabasayyaswamy Basayya, and Srinivas Devendrappa Lokikere. "Efficacy of 5-HT1F agonist versus CGRP-antagonists for treatment of acute migraine: A systematic review and network meta-analysis." National Journal of Physiology, Pharmacy and Pharmacology 13 (2023), 224-233. doi:10.5455/njppp.2023.13.062861202220062022



MLA (The Modern Language Association) Style

Hiremath, Sharanabasayyaswamy Basayya, and Srinivas Devendrappa Lokikere. "Efficacy of 5-HT1F agonist versus CGRP-antagonists for treatment of acute migraine: A systematic review and network meta-analysis." National Journal of Physiology, Pharmacy and Pharmacology 13.2 (2023), 224-233. Print. doi:10.5455/njppp.2023.13.062861202220062022



APA (American Psychological Association) Style

Hiremath, S. B. & Lokikere, . S. D. (2023) Efficacy of 5-HT1F agonist versus CGRP-antagonists for treatment of acute migraine: A systematic review and network meta-analysis. National Journal of Physiology, Pharmacy and Pharmacology, 13 (2), 224-233. doi:10.5455/njppp.2023.13.062861202220062022