Krymchantowski Abouch Valenty, Carneiro Henrique, Barbosa Jackeline, Jevoux Carla
Headache Center of Rio, Rio de Janeiro, RJ, Brazil.
Arq Neuropsiquiatr. 2008 Jun;66(2A):216-20. doi: 10.1590/s0004-282x2008000200015.
Nonsteroidal anti-inflammatory drugs (NSAID) are effective to treat migraine attacks. Lysine clonixinate (LC) and dipyrone (metamizol) have been proven effective to treat acute migraine. The aim of this study was to evaluate the efficacy and tolerability of the intravenous formulations of LC and dipyrone in the treatment of severe migraine attacks.
Thirty patients (28 women, 2 men), aged 18 to 48 years with migraine according the International Headache Society (IHS) (2004) were studied. The patients were randomized into 2 groups when presenting to an emergency department with a severe migraine attack. The study was single-blind. Headache intensity, nausea, photophobia and side effects were evaluated at 0, 30, 60 and 90 minutes after the drug administration. Rectal indomethacin as rescue medication (RM) was available after 2 hours and its use compared between groups.
All patients completed the study. At 30 minutes, 0% of the dipyrone group 13% of the LC group were pain free (p=0.46). At 60 and 90 minutes, 2 (13%) and 5 (33%) patients from the dipyrone group and 11 (73%) and 13 (86.7%) patients from the LC group were pain free (p<0.001). At 60 minutes, significantly more patients from the LC group were nausea-free (p<0.001). Regarding photophobia, there were no differences between groups at 60 minutes (p=0.11). The use of RM at 2 hours did not differ among groups (p=0.50). Pain in the site of the injection was reported by more patients of the LC group compared to the dipyrone group (p<0.0001).
LC is significantly superior to dipyrone in treating severe migraine attacks. LC promotes significantly more burning at the site of the injection.
非甾体抗炎药（NSAID）对治疗偏头痛发作有效。氯尼辛赖氨酸（LC）和安乃近已被证实对治疗急性偏头痛有效。本研究的目的是评估LC和安乃近静脉制剂治疗重度偏头痛发作的疗效和耐受性。
研究了30例年龄在18至48岁、符合国际头痛协会（IHS）（2004年）偏头痛诊断标准的患者（28名女性，2名男性）。当这些患者因重度偏头痛发作到急诊科就诊时，被随机分为2组。该研究为单盲研究。在给药后0、30、60和90分钟评估头痛强度、恶心、畏光和副作用。2小时后可使用直肠吲哚美辛作为急救药物（RM），并比较两组的使用情况。
所有患者均完成研究。30分钟时，安乃近组0%、LC组13%的患者疼痛消失（p = 0.46）。60和90分钟时，安乃近组分别有2例（13%）和5例（33%）患者、LC组分别有11例（73%）和13例（86.7%）患者疼痛消失（p < 0.001）。60分钟时，LC组无恶心症状的患者明显更多（p < 0.001）。关于畏光，60分钟时两组之间无差异（p = 0.11）。2小时时RM的使用在两组之间无差异（p = 0.50）。与安乃近组相比，LC组更多患者报告注射部位疼痛（p < 0.0001）。
在治疗重度偏头痛发作方面，LC明显优于安乃近。LC在注射部位引起的烧灼感明显更多。
