Späth M, Stratz T, Färber L, Haus U, Pongratz D
Friedrich-Baur-Institute, University of Munich, Munich, Germany.
Scand J Rheumatol Suppl. 2004;119:63-6. doi: 10.1080/03009740410007087.
Previous studies evaluating the efficacy and tolerance of tropisetron for the treatment of fibromyalgia (FM) used the drug either intravenously or orally, and at different dosage levels ranging from 2 mg to 15 mg daily. The shortest treatment was a single dose and the longest treatment period covered 28 days. A significant reduction of the pain intensity was achieved by using tropisetron 5 mg per day. Apart from the fact that treatment periods were different, the efficacy of oral and intravenous administration did not differ significantly. Tropisetron was well tolerated; but in the 15 mg group in one of the studies, the decrease in pain was less than in the placebo group, however, the frequency of constipation and other gastrointestinal symptoms increased. Furthermore, it was hypothesized that due to the impacts of CYP2D6 activities, a daily dose of tropisetron 2 mg may be efficacious in slow metabolizers only. Although tropisetron proved to be efficacious in a group of fibromyalgia patients, the dose-response curves cannot yet be explained in a fully satisfactory manner, which may encourage research focusing on possible subgroups of FM.
以往评估托烷司琼治疗纤维肌痛（FM）疗效和耐受性的研究，采用静脉或口服给药，日剂量范围为2毫克至15毫克不等。最短治疗为单次给药，最长治疗期为28天。每日服用5毫克托烷司琼可显著降低疼痛强度。除治疗期不同外，口服和静脉给药的疗效无显著差异。托烷司琼耐受性良好；但在其中一项研究的15毫克组中，疼痛减轻程度低于安慰剂组，然而便秘和其他胃肠道症状的发生率增加。此外，据推测，由于CYP2D6活性的影响，每日2毫克托烷司琼可能仅对慢代谢者有效。尽管托烷司琼在一组纤维肌痛患者中被证明有效，但剂量反应曲线尚未得到完全令人满意的解释，这可能会促使针对FM可能亚组的研究。
