University Centre for Adaptive Disorders and Headache (UCADH), Section of Pavia, Headache Medicine Centre, Polyclinic of Monza, Via Mondino 2, 27100 Pavia, Italy.
Expert Rev Neurother. 2010 Mar;10(3):351-64. doi: 10.1586/ern.09.160.
Almotriptan is a serotonin (5-hydroxytryptamine)(1B/1D) receptor agonist (triptan) that has shown consistent efficacy in the acute treatment of migraine with excellent tolerability. It is an effective, well-tolerated and cost-effective triptan, as demonstrated by improvement in rigorous, patient-orientated end points, such as 'sustained pain-free without adverse events'. Results from post hoc analyses, observational studies and well-controlled, prospective clinical trials have shown that significant improvements can be achieved if almotriptan 12.5 mg is administered within an hour of migraine onset, particularly when pain is mild, rather than waiting until pain is moderate-to-severe. Benefits were also achieved with early treatment of moderate-to-severe pain. Time-to-treatment was the best predictor of headache duration, whereas initial headache intensity best predicted most other efficacy outcomes. Early administration of almotriptan 12.5 mg not only produced rapid symptomatic relief, it also improved the patient's quality of life and ability to resume normal daily functioning. Furthermore, the efficacy of almotriptan is not significantly affected by allodynia (purported to reduce the efficacy of triptans). Thus, the excellent efficacy and tolerability profile of almotriptan administered early in a migraine attack indicate that it may be a first-line treatment option in this common, underdiagnosed and undertreated disorder.
阿莫曲坦是一种血清素（5-羟色胺）（1B/1D）受体激动剂（曲坦类药物），在偏头痛的急性治疗中显示出一致的疗效，且具有良好的耐受性。它是一种有效、耐受性良好且具有成本效益的曲坦类药物，这一点已通过严格的、以患者为导向的终点改善得到证明，例如“无不良事件的持续无疼痛”。事后分析、观察性研究和精心控制的前瞻性临床试验结果表明，如果在偏头痛发作后 1 小时内给予阿莫曲坦 12.5mg，特别是在疼痛较轻而不是等到疼痛中度至重度时，可显著改善疼痛缓解。中度至重度疼痛的早期治疗也能取得获益。治疗时间是头痛持续时间的最佳预测指标，而初始头痛强度则最好预测大多数其他疗效结局。早期给予阿莫曲坦 12.5mg 不仅能迅速缓解症状，还能改善患者的生活质量和恢复正常日常功能的能力。此外，阿莫曲坦的疗效不受痛觉过敏（据推测会降低曲坦类药物的疗效）的显著影响。因此，在偏头痛发作早期给予阿莫曲坦的良好疗效和耐受性表明，它可能是这种常见、诊断不足和治疗不足的疾病的一线治疗选择。
