[托吡酯与纳多洛尔在独立患者系列中预防性治疗发作性偏头痛有效性的比较研究]

[Comparative study of the effectiveness of topiramate and nadolol in the preventive treatment of episodic migraine in independent series of patients].

作者信息

Gracia-Naya Manuel, Huerta-Villanueva Mariano, Ríos-Gómez Consuelo, Latorre-Jiménez Ana M, Sánchez-Valiente Sara, Santos-Lasaosa Sonia, Mauri-Llerda José Angel, García-Gómara M José, Artal-Roy Jorge

机构信息

Servicio de Neurología, Hospital Universitario Miguel Servet, Zaragoza, España.

出版信息

Rev Neurol. 2010 May 1;50(9):513-9.

PMID:20443169

Abstract

INTRODUCTION

Topiramate and nadolol with levels A and C of scientific evidence, respectively, would be indicated as preventive treatments of migraine. To date only one study of satisfaction has been carried out to compare the two pharmaceuticals.

AIM

To compare the effectiveness parameters in independent groups of patients treated preventively with one of the pharmaceuticals from the study.

PATIENTS AND METHODS

From a database of 700 patients with migraine, those with episodic migraine and who had followed a course of preventive treatment, for the first time, with topiramate or nadolol were selected for the study. The effectiveness variables (reduction in the number of crises at four months of preventive treatment and responder rates) were analysed.

RESULTS

Altogether 208 patients with were included for treatment: 140 with topiramate (77.8% females; mean age, 37.9) and 68 with nadolol (69% females; mean age, 36.9). The mean number of crises in the month prior to treatment was: topiramate group, 6.3 +/- 2.6; nadolol group 5.3 +/- 2.0 (p = 0.0066). At four months after starting treatment: topiramate group, 2.69 +/- 2.6; nadolol group 2.6 +/- 2.2 (NS). The percentage of reduction in the number of migraines was 56.6% with topiramate and 51.6% with nadolol (NS). The responder rate (reduction in the frequency of crises by at least 50%) was 71.3% with topiramate versus 69% with nadolol (NS). The excellent response rate (reduction in crises by at least 75%) was 53.3% with topiramate versus 32.2% with nadolol (p = 0.0077). Adverse side effects were reported by 54% of patients treated with topiramate versus 30.8% of those treated with nadolol (p = 0.0015). The rate of satisfaction was 61% for the topiramate group and 71% for the group with nadolol (NS).

CONCLUSIONS

Both topiramate and nadolol proved to be effective in the preventive treatment of episodic migraine. Topiramate was found to be more effective than nadolol, although it was used in patients with a higher frequency of crises, and was not tolerated so well.

摘要

引言

托吡酯和纳多洛尔的科学证据级别分别为A和C，可作为偏头痛的预防性治疗药物。迄今为止，仅进行了一项关于满意度的研究来比较这两种药物。

目的

比较在接受该研究中其中一种药物预防性治疗的独立患者组中的有效性参数。

患者和方法

从一个包含700例偏头痛患者的数据库中，选择首次接受托吡酯或纳多洛尔预防性治疗疗程的发作性偏头痛患者进行研究。分析有效性变量（预防性治疗四个月时发作次数的减少和有效率）。

结果

总共纳入208例患者进行治疗：140例使用托吡酯（女性占77.8%；平均年龄37.9岁），68例使用纳多洛尔（女性占69%；平均年龄36.9岁）。治疗前一个月的平均发作次数为：托吡酯组6.3±2.6次；纳多洛尔组5.3±2.0次（p = 0.0066）。开始治疗四个月后：托吡酯组2.69±2.6次；纳多洛尔组2.6±2.2次（无显著性差异）。托吡酯治疗后偏头痛发作次数减少的百分比为56.6%，纳多洛尔为51.6%（无显著性差异）。有效率（发作频率至少降低50%）托吡酯为71.3%，纳多洛尔为69%（无显著性差异）。优秀反应率（发作次数至少降低75%）托吡酯为53.3%，纳多洛尔为32.2%（p = 0.0077）。接受托吡酯治疗的患者中有54%报告有不良反应，而接受纳多洛尔治疗的患者中这一比例为30.8%（p = 0.0015）。托吡酯组的满意度为61%，纳多洛尔组为71%（无显著性差异）。