To Triptans Alternative: New drugs in acute migraine

Active substances from the group of the so-called triptans are the drugs of first choice in moderate-to-severe migraine attacks. Because of its vasoconstrictor effect, some people should not take these medicines, however. For these patients, two new drugs have been developed classes: the “Ditane” and the “Gepante”. The German society for neurology (DGN) reported.

To relieve a severe migraine attack, were previously used only triptans available. These drugs are very effective, however, you have a property that prohibits some of the patients they take: they constrict the blood vessels and in the meninges, where it is used for effect against migraine desired. In other areas of the body, this effect is shown. As a result, the intake can be from the Triptans dangerous to life, if certain risk factors for cardiovascular be diseases, or a Patient has already had a heart attack or stroke. For these people new drugs were developed, which are currently in the clinical trial.

The first group of "Ditane" the drug Lasmiditan is part of. He acts similar to a Triptan, but has no vasoconstrictor effect. In two large Phase 3 studies of Lasmiditan was more effective in the Acute treatment of a Migraine more than Placebo. The substance can, however, call unpleasant side effects such as drowsiness or dizziness.

The second new approach in the treatment of the migraine attack are called "Gepante". In a larger randomized, Placebo-controlled studies for the treatment of acute attacks of Migraine, the active ingredients were investigated Ubrogepant and Rimegepant. Both are more effective than Placebo and, in contrast to Lasmiditan, only minor side effects.

As yet no direct comparison studies with the Triptans are. However, it is assumed that both classes of substances are less effective than triptans, explains Professor Dr. Hans-Christoph Diener, spokesman of the DGN. Nevertheless, he welcomes the new developments: "They are for patients with severe migraine, in whom triptans are contraindicated, a long-awaited and important therapy option. It must not be forgotten that there was for these patients, yet no acute therapy of migraine."

The spectrum of medicinal products has expanded for patients with migraine in the past few years. So, antibodies are now available to prevent migraine attacks effectively and the seizure frequency, reduce ( reported).



DOI 10.1177/0333102410370873 DOI 10.1093/brain/awz134

DOI 10.1212/WNL.0000000000006641

DOI 10.1177/0333102416653233

DOI 10.1016/S0140-6736(19)31606-X

DOI 10.1056/NEJMoa1811090

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