An announcement was recently made that lasmiditan, a new medication for the treatment of migraine attacks, developed by Eli Lilly, will not be available in Canada.

This news was disappointing as more options are always welcome and needed for people with migraine.

Lasmiditan acts on serotonin receptors, similar to the well-known triptans. It is different from triptans because it targets a different serotonin receptor (5HT1F to be precise, triptans target 5HT1B/D). One key advantage of lasmiditan is that it does not constrict arteries (triptans do), and could have been an option for some people who cannot use triptans due to cardiovascular issues (stroke, heart disease).

We have attached a link to the Regulatory Decision Summary issued by Health Canada outlining the reasons the submission to Health Canada was cancelled.  As a reminder, Health Canada evaluates all new medications based on scientific research on efficacy and safety.

Click here to read the regulatory decision summary.

The paragraph of interest reads as following:

«At the time of cancellation, the review of the submission was complete. Health Canada did not identify any deficiencies in the data packages that would have precluded issuing an approval. However, Health Canada and the sponsor could not reach agreement on the interpretation of the cardiovascular data and resulting content in the Product Monograph. The sponsor made the decision to cancel the submission before a negative decision could be issued by Health Canada.»

What does that mean? We can assume that Health Canada intended to include restrictions regarding cardiovascular safety that Eli Lilly, the maker of lasmiditan, did not agree with. Interpreting scientific data is not an easy task!

In the end, this is unfortunate. Still, other new acute treatments are on the way, including the gepants (stay tuned for a review of this new class).

This remains a hopeful time for Canadians living with migraine. Research is the way forward for new treatments!

Written: June 2021