{
  "abstract": "Aim: Rimegepant and lasmiditan are effective acute migraine treatments, but real-world head-to-head comparative data are lacking. We aimed to compare their effectiveness and tolerability in clinical practice.\n\nMethods: This post-hoc study indirectly compared two prospective, multicenter, real-world studies (GAINER and DART). Participants treated up to four migraine attacks with rimegepant 75 mg orally disintegrating tablets or lasmiditan 50 or 100 mg. Data were collected using an electronic diary every 30 min up to 2 hours after dosing. The co-primary outcomes were 2-hour pain freedom and incidence of adverse events (AEs) comparing rimegepant with lasmiditan in the first treated attack.\n\nResults: The overall cohort included 249 individuals, 58 treated with lasmiditan and 191 with rimegepant (81.1% females, age 45.8 [43.4–48.1] years, 9.6 [8.3 – 10.8] monthly migraine days, 26.9% with chronic migraine). Pain freedom 2-hour post dose in the first treated attack was comparable between rimegepant and lasmiditan (43.5%, n = 83 vs. 32.8%, n = 19, p = 0.171). The relative risk (RR) of achieving 2-hour pain freedom with lasmiditan versus rimegepant was 0.75 [0.50 – 1.28] (p = 0.169). The percentage of participants who reported at least one AE in the first treated attack was higher with lasmiditan than with rimegepant (53.4% vs. 11.5%; RR 4.64 [2.93–7.35], p < 0.001).\n\nConclusion: Lasmiditan and rimegepant demonstrated comparable effectiveness, although more participants reported AEs after lasmiditan intake. Nonetheless, this indirect comparison warrants further confirmation.\n\nTrial registration: GAINER registration at www.clinicaltrial.gov: NCT05903027; DART registration at www.clinicaltrial.gov: NCT05903040.\n\nSupplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s10072-026-09510-6.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy",
    "Headache Science and Neurorehabilitation Unit, IRCCS Mondino Foundation, Pavia, Italy",
    "Digital and Predictive Medicine, Pharmacology and, Clinical Metabolic Toxicology-Headache Center and Drug Abuse-Laboratory of Clinical Pharmacology and Pharmacogenomics, AOU Policlinico Di Modena, Modena, Italy",
    "Department of Medico-Surgical Sciences and Biotechnologies, Polo, Pontino, Sapienza University of Rome, C.So Della Repubblica 79, 04100 Latina, Italy",
    "Department of Neurosciences “Rita Levi Montalcini”, University of Turin, Turin, Italy",
    "Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy",
    "Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, 67100 L’Aquila, Italy",
    "Department of Health Sciences, University of Florence, Florence, Italy",
    "Headache Center, Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences, University of Campania ‘Luigi Vanvitelli’, Naples, Italy",
    "Headache Center of Clinical Neurology of Istituto Clinico Città Di Brescia, Brescia, Italy",
    "Neuroalgology Unit and Headache Center, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy",
    "L. Amaducci” Neurological Clinic, University of Bari, Bari, Italy",
    "IRCCS Istituto Delle Scienze Neurologiche Di Bologna, UOC Clinica Neurologica Metropolitana - Programma Cefalee Ed Algie Facciali, Bologna, Italy",
    "Neurology Unit, Ospedale Santo Stefano, USL Toscana Centro, Prato, Italy",
    "Headache Centre, Neurology - Euganea, Health Unit, Padua, Italy",
    "Clinical Neurology Azienda Sanitaria Friuli Centrale. Department of Medicine, University of Udine, Udine, Italy",
    "Department of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy",
    "Headache Centre, Clinical Unit of Neurology, School of Neurology, Department of Medicine, Surgery and Health Sciences, University Hospital and Health Services, ASUGI, University of Trieste, Trieste, Italy",
    "Unit of Neurology, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy",
    "Department of Neurosciences, AOU Renato Dulbecco, Catanzaro, Italy",
    "Department of Neurology- Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Milan, Italy"
  ],
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  "bibtex": "https://research.draconitic.com/paper/evb8842vjwyee.bib",
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  "doi": "10.1007/s10072-026-09510-6",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13736438/",
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  "language": "en",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
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  "pmcid": "PMC13736438",
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  "published": "2026-11-05",
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  "title": "Effectiveness and safety of lasmiditan and rimegepant in the acute migraine treatment: an indirect real-world comparison",
  "title_text": "Effectiveness and safety of lasmiditan and rimegepant in the acute migraine treatment: an indirect real-world comparison",
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  "updated_at": "2026-11-09T12:21:53Z",
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  "venue": "Neurological Sciences",
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