Danish Headache Centre, Department of Neurology, University of Copenhagen, Glostrup Hospital, Glostrup, Denmark.
Headache. 2011 Jan;51(1):118-23. doi: 10.1111/j.1526-4610.2010.01797.x. Epub 2010 Nov 10.
In 3 randomized clinical trials (n = 1585) the calcitonin gene-related peptide antagonist telcagepant 300 mg orally had an incidence of adverse events similar to placebo when used in the acute treatment of migraine. Telcagepant, thus, has excellent tolerability in migraine. Only a quarter (26%) (334/1307) of patients were, however, pain free after 2 hours, while 56% (729/1297) of patients had pain relief at 2 hours. Telcagepant 300 mg in one randomized clinical trial was equipotent to zolmitriptan 5 mg. Based on results from a meta-analysis, rizatriptan 10 mg (41%) and almotriptan (35%) seem superior to telcagepant (26%) for pain free at 2 hours whereas rizatriptan 10 mg (25%) showed no difference from telcagepant 300 mg (19 %) for sustained pain free (2-24 hours). The introduction of calcitonin gene-related peptide receptor antagonism in the acute treatment of migraine is a major step forward but so far mostly because of its specific mode of action and excellent tolerability.
在 3 项随机临床试验（n = 1585）中，在偏头痛的急性治疗中，口服降钙素基因相关肽拮抗剂 telcagepant 300mg 的不良反应发生率与安慰剂相似。因此，telcagepant 在偏头痛中具有极好的耐受性。然而，仅有四分之一（26%）（334/1307）的患者在 2 小时后无疼痛，而 56%（729/1297）的患者在 2 小时时有疼痛缓解。在一项随机临床试验中，telcagepant 300mg 与佐米曲普坦 5mg 等效。基于荟萃分析的结果，利扎曲普坦 10mg（41%）和阿莫曲普坦（35%）似乎比 telcagepant（26%）在 2 小时时无疼痛方面更优，而利扎曲普坦 10mg（25%）与 telcagepant 300mg（19%）在持续无疼痛（2-24 小时）方面无差异。降钙素基因相关肽受体拮抗剂在偏头痛的急性治疗中的引入是向前迈出的重要一步，但到目前为止，主要是因为其特定的作用模式和极好的耐受性。
