大人のエピソード性片頭痛の急性治療: 系統的レビューとメタ解析
Juliana H VanderPluym1,2, Rashmi B Halker Singh1,2, Meritxell Urtecho1,3
1Mayo Clinic Evidence-based Practice Center, Rochester, Minnesota.
JAMA
|June 15, 2021
まとめ
トリプトンやNSAIDを含むいくつかの急性片頭痛治療は,軽度の副作用で痛みを効果的に軽減します. オピオイドの証拠は限られているが,非薬学的選択肢も有望である.
科学分野:
- 神経学
- 薬理学について
- 証拠 に 基づく 医学
背景:
- 片頭痛は一般的な神経疾患で,大きな罹患率を引き起こします.
- 効果的な急性治療は 偏頭痛発作の管理に不可欠です
研究 の 目的:
- 成人におけるエピソード性片頭痛の様々な急性治療の利害を体系的に評価する.
- ランダム化臨床試験と体系的なレビューからの証拠を合成する.
主な方法:
- 2021年2月までの複数のデータベースで包括的な文献検索を実施しました.
- ランダム化臨床試験と急性片頭痛の治療法を評価する系統的レビューが含まれています.
- ランダム効果または固定効果モデルを使ったメタ分析技術を使用した.
主要な成果:
- トリプトンとNSAIDは,軽度の有害事象 (中等から高いSOE) とともに,痛みを大幅に軽減しました.
- カルシトニン遺伝子のペプチド抗体,ラスミディタン,ディヒドロエルゴタミン,アセトアミノフェン,およびいくつかの非薬学的治療法も有効であることが示された.
- オピオイドの証拠は限られ,神経調節のような非薬学的治療は,副作用の増加なしに,痛みの改善のための中等レベルのSOEを示しました.
結論:
- 薬理学的および非薬理学的選択肢を含む複数の急性治療は,エピソード性片頭痛に有効です.
- オピオイドのような特定の介入のデータは限られています
- トリプトン,NSAID,アセトアミノフェン,非薬学的治療は,急性片頭痛の治療に有効な選択肢です.
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