Kiel Headache and Pain Centre, Schmerzklinik Kiel, Kiel, Germany.
Int J Clin Pract. 2011 Aug;65(8):879-86. doi: 10.1111/j.1742-1241.2011.02720.x.
The 'Migraine Intervention Score' (MIS) is a new self-administered scale that can be used to quantify the severity of specific migraine symptoms. The objective of this study was to determine if MIS could be used to improve the efficacy of frovatriptan 2.5 mg in the early treatment of migraine attacks for clinical practice.
In this prospective observational study, patients suffering from migraines with or without aura were enrolled and permitted to choose the time of self-medication with frovatriptan 2.5 mg. At the time of intake of medication, patients evaluated the severity of individual migraine symptoms using MIS. The scores for each symptom were then totalled to provide an overall level of symptom severity. A total of 1620 patients completed the treatment of three migraine attacks with frovatriptan. A total of 1518 patients could be analysed with respect to the documented efficacy parameters of the third attack. Patients initiating treatment at low symptom severity levels were compared with those initiating treatment at high symptom severity levels.
Time to the achievement of the primary endpoint (headache response) was significantly lower in patients who initiated treatment at low vs. high symptom severity levels (42.06 ± 32.33 vs. 49.25 ± 34.92 min; p = 0.0023). Likewise, patients who initiated treatment at low symptom severity levels achieved complete headache relief more rapidly (79.37 ± 65.33 vs. 96.05 ± 100.85 min; p = 0.0109) and required escape medication less frequently (3.88% vs. 13.73%; p < 0.0001).
The initiation of attack treatment with frovatriptan at low severity of migraine symptoms is more effective than starting therapy at higher symptom levels. Together with the low recurrence headache rate, the decreased necessity for escape medication and the low number of tablets needed, these data demonstrate that operationalised intervention with frovatriptan 2.5 mg is a valuable method for improving the treatment of migraine attacks.
“偏头痛干预评分”（MIS）是一种新的自我管理量表，可用于量化特定偏头痛症状的严重程度。本研究的目的是确定 MIS 是否可用于提高氟伐曲坦 2.5mg 在偏头痛发作早期治疗中的疗效，以用于临床实践。
在这项前瞻性观察性研究中，纳入了有或无先兆偏头痛的患者，并允许他们选择自行服用氟伐曲坦 2.5mg 的时间。在服用药物时，患者使用 MIS 评估每个偏头痛症状的严重程度。然后将每个症状的评分相加，以提供整体症状严重程度的评分。共有 1620 例患者完成了氟伐曲坦治疗三次偏头痛发作的治疗。共有 1518 例患者可根据第三次发作的记录疗效参数进行分析。与高症状严重程度水平相比，低症状严重程度水平开始治疗的患者达到主要终点（头痛缓解）的时间显著更短（42.06 ± 32.33 与 49.25 ± 34.92 分钟；p = 0.0023）。同样，低症状严重程度水平开始治疗的患者更快达到完全头痛缓解（79.37 ± 65.33 与 96.05 ± 100.85 分钟；p = 0.0109），需要服用解救药物的频率更低（3.88%与 13.73%；p < 0.0001）。
在偏头痛症状严重程度较低时开始氟伐曲坦治疗发作比在较高症状水平开始治疗更有效。结合低复发头痛率、减少解救药物的必要性以及所需片剂数量减少，这些数据表明，氟伐曲坦 2.5mg 的操作化干预是改善偏头痛发作治疗的一种有价值的方法。
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