多机制(舒马曲坦-萘普生)早期干预用于偏头痛的急性治疗

Multimechanistic (sumatriptan-naproxen) early intervention for the acute treatment of migraine.

作者信息

Silberstein S D, Mannix L K, Goldstein J, Couch J R, Byrd S C, Ames M H, McDonald S A, Lener S E, Toso Cynthia

机构信息

Jefferson Headache Center, 111 South 11th Street, Suite 8130, Philadelphia, PA 19107, USA.

出版信息

Neurology. 2008 Jul 8;71(2):114-21. doi: 10.1212/01.wnl.0000316800.22949.20.

Abstract

BACKGROUND

Research suggests treating a migraine at the first sign of pain increases the likelihood of the best clinical outcome.

OBJECTIVE

To investigate the efficacy and tolerability of a fixed-dose, single-tablet formulation of sumatriptan 85 mg, formulated with RT Technology, and naproxen sodium 500 mg (sumatriptan/naproxen) as early intervention acute therapy for migraine.

METHODS

Patients (aged 18 to 65 years) with International Headache Society-defined migraine with or without aura were enrolled in one of two identically designed, randomized, double-blind, parallel group, placebo-controlled studies. Patients treated a single migraine within 1 hour of onset of migraine head pain and while the pain was mild with either sumatriptan/naproxen or placebo. The primary efficacy measure was the percentage of patients who became pain-free 2 hours postdose.

RESULTS

Intent-to-treat analyses consisted of 576 and 535 migraineurs. At 2 hours, 52% and 51% of sumatriptan/naproxen-treated patients were pain free, as compared to 17% and 15% of placebo-treated patients (p < 0.001). Significant pain-free responses in favor of sumatriptan/naproxen were demonstrated as early as 30 minutes, maintained at 1 hour, and sustained from 2 to 24 hours. At 2 and 4 hours, sumatriptan/naproxen provided significantly lower rates of traditional migraine-associated symptoms (nausea, photophobia, and phonophobia) and nontraditional migraine-associated symptoms (neck pain/discomfort and sinus pain/pressure). The most commonly reported adverse events were nausea (< or =4%) and dizziness (< or =2%).

CONCLUSION

The fixed-dose single-tablet formulation of sumatriptan/naproxen was effective and well tolerated in an early intervention paradigm for the acute treatment of migraine, including traditional and nontraditional symptoms.

摘要

背景

研究表明在偏头痛疼痛的最初迹象出现时进行治疗可提高获得最佳临床疗效的可能性。

目的

研究采用RT技术配制的85毫克舒马曲坦与500毫克萘普生钠的固定剂量单一片剂制剂(舒马曲坦/萘普生)作为偏头痛早期干预急性治疗的疗效和耐受性。

方法

国际头痛协会定义的有或无先兆偏头痛患者(年龄18至65岁)入选两项设计相同、随机、双盲、平行组、安慰剂对照研究之一。患者在偏头痛性头痛发作1小时内且疼痛轻微时,用舒马曲坦/萘普生或安慰剂治疗单次偏头痛。主要疗效指标是给药后2小时疼痛缓解的患者百分比。

结果

意向性分析纳入了576例和535例偏头痛患者。2小时时,舒马曲坦/萘普生治疗的患者中分别有52%和51%疼痛缓解,而安慰剂治疗的患者中分别为17%和15%(p<0.001)。早在30分钟时就显示出有利于舒马曲坦/萘普生的显著疼痛缓解反应,在1小时时保持,从2小时到24小时持续。在2小时和4小时时,舒马曲坦/萘普生使传统偏头痛相关症状(恶心、畏光和畏声)和非传统偏头痛相关症状(颈部疼痛/不适和鼻窦疼痛/压痛)的发生率显著降低。最常报告的不良事件是恶心(≤4%)和头晕(≤2%)。

结论

舒马曲坦/萘普生固定剂量单一片剂制剂在偏头痛急性治疗的早期干预模式中有效且耐受性良好,包括传统和非传统症状。

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