在伦敦的第三级头痛中心,三胺无反应:我们能从中学到什么? 一个回顾性研究研究
Robyn-Jenia Wilcha1, Peter J Goadsby1,2
1NIHR King's Clinical Research Facility, SLaM Biomedical Research Centre, and Wolfson Sensory, Pain and Regeneration Centre, King's College London, London, UK.
Cephalalgia : an international journal of headache
|September 9, 2024
概括
许多偏头痛患者对三类药物没有反应,超过60%的人没有反应. 临床医生应该考虑替代性急性治疗方法,如或,以更好地管理偏头痛.
科学领域:
- 神经学 神经学
- 药理学 药理学是指药理学的学科.
背景情况:
- 三类药物是急性偏头痛治疗的基石,但由于疗效和耐受性问题,患者的反应有很大差异.
- 欧洲头痛联合会 (EHF) 已经为三药不响应制定了标准化定义,但流行数据仍然有限.
研究的目的:
- 在现实临床环境中评估三非响应,三耐药性和三折射率的患病率.
- 在成年偏头痛患者中确定与三胺无反应相关的因素.
主要方法:
- 来自伦敦的第三级头痛服务的诊所信件的两年服务评估.
- 将419名成年偏头痛患者纳入评估基于EHF定义的三胺反应.
主要成果:
- 观察到特里普坦无反应的高患病率 (63.8%),其中37.7%被归类为特里普坦耐药和4.6%被归类为特里普坦耐火.
- 随着年龄的增长和药物过度使用与平素反应的增加有关,而更失败的预防性治疗和使用CGRP单克隆抗体与平素无反应相关.
- 埃利特里普坦显示了最高的响应率 (49.5%),其次是鼻腔佐尔米特里普坦 (44.4%) 和瑞扎特里普坦 (35.7%).
结论:
- 这项研究揭示了在第三级头痛服务中接受治疗的成年偏头痛患者中,平素无反应率令人担忧.
- 临床医生必须通过考虑替代性三药,早期干预或不同的药物类别,如虫或迪坦来优化急性治疗.
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