Schürks Markus, Rosskopf Dieter, de Jesus Janete, Jonjic Mira, Diener Hans-Christoph, Kurth Tobias
Department of Neurology, University of Duisberg-Essen, Hufelandstrasse 55, 45122 Essen, Germany.
Headache. 2007 Jul-Aug;47(7):1079-84. doi: 10.1111/j.1526-4610.2007.00862.x.
Oxygen and triptans are drugs of first choice to abort cluster headache attacks. However, clinical predictors of treatment response are unavailable.
We aimed to identify predictors of acute treatment response among patients with cluster headache.
We investigated 246 cluster headache patients with available information on personal, headache, and lifestyle characteristics as well as effectiveness of acute medication use. We used logistic regression models to identify potential predictors of triptan and oxygen response.
Triptans were effective in 137 of the 191 users and oxygen in 134 of the 175 users. We only identified increasing age (OR 0.96, 95% CI 0.93-0.99; P= .013) as a negative predictor for triptan response, while nausea/vomiting (OR 0.41, 95% CI 0.18-0.91; P= .029) and restlessness (OR 0.09, 95% CI 0.01-0.66; P= .019) were negative predictors of oxygen response.
Few clinical features seem to predict treatment nonresponse in cluster headache. More refined studies aiming at physiological and genetic characteristics seem promising in the future.
氧气和曲坦类药物是终止丛集性头痛发作的首选药物。然而，治疗反应的临床预测指标尚不清楚。
我们旨在确定丛集性头痛患者急性治疗反应的预测指标。
我们调查了246例丛集性头痛患者，他们提供了个人、头痛和生活方式特征以及急性药物使用效果等信息。我们使用逻辑回归模型来确定曲坦类药物和氧气反应的潜在预测指标。
191名使用曲坦类药物的患者中有137例有效，175名使用氧气的患者中有134例有效。我们仅确定年龄增长（比值比0.96，95%置信区间0.93 - 0.99；P = 0.013）是曲坦类药物反应的负性预测指标，而恶心/呕吐（比值比0.41，95%置信区间0.18 - 0.91；P = 0.029）和坐立不安（比值比0.09，95%置信区间0.01 - 0.66；P = 0.019）是氧气反应的负性预测指标。
似乎很少有临床特征能预测丛集性头痛的治疗无反应。未来针对生理和遗传特征的更精细研究似乎很有前景。
