Lanepitant is a high-affinity, selective
neurokinin-1 receptor (NK-1) and is effective in the dural
inflammation model of acute
migraine.
Lanepitant 30, 80, and 240 mg given orally was evaluated in a double-blind, placebo-controlled crossover study to determine its effect in reducing
migraine pain and severity of associated symptoms. Outpatients treated four
migraine headaches of moderate or severe
pain intensity with study
drug according to a randomization schedule. They recorded their
pain intensity and severity of
migraine-associated symptoms at 30, 60, 90, and 120 min. Although 53 patients were randomly allocated to a treatment sequence, only 40 patients completed all treatments. There was no statistically significant difference in improvement in
migraine pain at any time for any of the treatments. Additionally, there was no change in severity of
migraine-associated symptoms associated with
lanepitant therapy. No adverse events could be attributed to
lanepitant.
Lanepitant was ineffective orally in treating acute
migraine in this trial. This may be due to poor bioavailability during a
migraine attack. Alternatively, the
neurogenic inflammation hypothesis may not apply to
migraine.