Moore Johanna C, Miner James R
Department of Emergency Medicine, Hennepin County Medical Center, Minneapolis, MN, USA.
Patient Prefer Adherence. 2012;6:27-37. doi: 10.2147/PPA.S19171. Epub 2012 Jan 4.
Subcutaneous sumatriptan is an effective treatment for pain from acute migraine headache, and can be used in patients with known migraine syndrome and in patients with primary headaches when secondary causes have been excluded. In limited comparative trials, subcutaneous sumatriptan performed in a manner comparable with oral eletriptan and intravenous metoclopramide, was superior to intravenous aspirin and intramuscular trimethobenzamide-diphenhydramine, and was inferior to intravenous prochlorperazine for pain relief. The most common side effects seen with subcutaneous sumatriptan are injection site reactions and triptan sensations. As with all triptans, there is a risk of rare cardiovascular events with subcutaneous sumatriptan and its use should be limited to those without known cerebrovascular disease and limited in those with known cardiovascular risk factors and unknown disease status. In studies of patient preference and tolerability, the subcutaneous formulation has a faster time of onset and high rate of efficacy when compared with the oral formulation, but the oral formulation appears to be better tolerated. It is important to consider the needs of the patient, their past medical history, and what aspects of migraine treatment are most important to the patient when considering treatment of acute migraine or primary headache. Subcutaneous sumatriptan is a good first-line agent for the treatment of pain from acute migraine headaches and primary headaches.
皮下注射舒马曲坦是治疗急性偏头痛疼痛的有效方法，可用于已知患有偏头痛综合征的患者以及已排除继发原因的原发性头痛患者。在有限的对照试验中，皮下注射舒马曲坦的疗效与口服依立曲坦和静脉注射甲氧氯普胺相当，优于静脉注射阿司匹林和肌肉注射三甲氧苯酰胺 - 苯海拉明，在缓解疼痛方面不如静脉注射丙氯拉嗪。皮下注射舒马曲坦最常见的副作用是注射部位反应和曲坦类药物相关感觉。与所有曲坦类药物一样，皮下注射舒马曲坦有发生罕见心血管事件的风险，其使用应限于无已知脑血管疾病的患者，对于有已知心血管危险因素和疾病状态不明的患者应限制使用。在患者偏好和耐受性研究中，与口服制剂相比，皮下制剂起效更快、疗效更高，但口服制剂似乎耐受性更好。在考虑治疗急性偏头痛或原发性头痛时，重要的是要考虑患者的需求、既往病史以及偏头痛治疗的哪些方面对患者最重要。皮下注射舒马曲坦是治疗急性偏头痛疼痛和原发性头痛的良好一线药物。
