Hämäläinen M, Jones M, Loftus J, Saiers J
Helsinki University Central Hospital for Children and Adolescents, Helsinki, Finland.
Int J Clin Pract. 2002 Nov;56(9):704-9.
This review considers the epidemiology, clinical manifestations and functional consequences of migraine in children and adolescents and surveys the studies establishing the efficacy and tolerability of sumatriptan nasal spray in this patient population. Although therapeutic advances in paediatric and adolescent migraine have lagged behind those in adult migraine, the first systematic studies of migraine medications in young patients have brought about progress in the past five years. These studies show that therapeutic approaches suitable for adult patients are not always applicable to paediatric and adolescent patients. Because of the unique characteristics of paediatric and adolescent migraine, it has been difficult to demonstrate in young patients the efficacy of oral sumatriptan and other triptan tablets, which are the medications of choice for adult migraine. With sumatriptan, this finding has proven to be a consequence of the form in which the drug was administered rather than the inherent properties of the drug. The availability of sumatriptan nasal spray allows the benefits of migraine-specific therapy to be extended to children and adolescents. In both well-controlled, single-episode studies and long-term, multiple-episode studies, sumatriptan nasal spray has been effective and well tolerated for the acute treatment of migraine in children and adolescents. Except for unpleasant taste, which is not significantly distressing to patients, sumatriptan nasal spray has a tolerability profile similar to thatof placebo in young patients.
本综述探讨了儿童和青少年偏头痛的流行病学、临床表现及功能影响，并调研了确立舒马曲坦鼻喷雾剂对该患者群体有效性和耐受性的研究。尽管儿童和青少年偏头痛的治疗进展落后于成人偏头痛，但在过去五年中，针对年轻患者偏头痛药物的首批系统性研究已取得进展。这些研究表明，适用于成年患者的治疗方法并不总是适用于儿童和青少年患者。由于儿童和青少年偏头痛具有独特特征，在年轻患者中很难证明口服舒马曲坦及其他曲坦类片剂（成人偏头痛的首选药物）的疗效。对于舒马曲坦，这一发现已证明是药物给药形式所致，而非药物的固有特性。舒马曲坦鼻喷雾剂的问世使偏头痛特异性疗法的益处得以扩展至儿童和青少年。在严格控制的单发作研究和长期多发作研究中，舒马曲坦鼻喷雾剂对儿童和青少年偏头痛的急性治疗均有效且耐受性良好。除了味道不佳（但对患者困扰不大）外，舒马曲坦鼻喷雾剂在年轻患者中的耐受性与安慰剂相似。
