Acute Migraine: Can the New Drugs Clinically Outpace?

Abstract

The objective of this article is to discuss and compare the latest approved drugs (lasmiditan, ubrogepant, and rimegepant) for the management of acute migraine in a clinically relevant manner, emphasizing on their efficacy, safety, as well as cost benefits. A PubMed, clincialtrials.gov , and USFDA literature search (2013–2019) was conducted using the following keywords: Lasmiditan; Ubrogepant; Rimegepant; Acute Migraine; 5HT1F; CGRP. We included only English language articles which discussed the efficacy, safety, and tolerability of newly approved drugs for acute migraine. Triptans and NSAIDs have constitutively been the go-to drugs for the management of acute attack of migraine. These three latest drugs (lasmiditan, ubrogepant, and rimegepant) approved by USFDA may prove to be a game-changer, especially for those migraineurs who have accompanying cardiovascular diseases or have been dissatisfied with the existing therapeutic options. Migraine is a chronic debilitating disease for which the therapeutic options are already available, but for a proportion of patients, these options get either contraindicated, or prove to be clinically ineffective, or crop-out as ill-suited due to the adverse effects. In such conditions, the recently approved three drugs by USFDA stand a chance to fulfill the unmet needs. But due to the paucity of head-on trials between different groups of drugs, it is still difficult to comment about which group may clinically outpace by providing better therapeutic gain.