Department of Neurology, Valduce Hospital, Como.
Neuropsychiatr Dis Treat. 2013;9:81-5. doi: 10.2147/NDT.S39373. Epub 2013 Jan 16.
Migraine often occurs during weekends. The efficacy of frovatriptan, naproxen sodium, or no therapy for the acute or prophylactic treatment of weekend migraineurs was tested in an open-label, nonrandomized pilot study.
Twenty-eight subjects (mean age 36 ± 12 years, including 18 females) suffering from migraine without aura were followed up for six consecutive weekends. No treatment was administered during the first two weekends. On the third and fourth weekends, patients were given frovatriptan 2.5 mg and on the fifth and sixth weekends naproxen sodium 500 mg. Treatment was taken on Saturday and Sunday morning, regardless of the occurrence of migraine. Efficacy was evaluated through a diary, where patients reported the severity of migraine on a scale from 0 (no migraine) to 10 (severe migraine) and use of rescue medication.
The migraine severity score was significantly lower with frovatriptan (4.8 [95% confidence interval (CI) 3.8-5.9]) than with naproxen sodium (5.7 [CI 5.1-6.4], P< 0.05 versus frovatriptan) or no therapy (6.6 [6.2-7.0], P< 0.01 versus frovatriptan). The difference in favor of frovatriptan was more striking in patients not taking rescue medication (frovatriptan, 1.9 [1.5-2.3]) versus naproxen sodium 3.6 [3.0-4.2], P< 0.001) and versus no therapy (5.1 [4.4-5.8], P< 0.001) and on the second day of treatment. The rate of use of rescue medication was significantly (P< 0.05) lower on frovatriptan (12.5%) than on naproxen sodium (31.3%) or no therapy (56.3%).
This pilot study provides the first evidence of the efficacy of a second-generation triptan as symptomatic or prophylactic treatment for weekend migraine.
偏头痛常发生在周末。在一项开放性、非随机的初步研究中,对曲普坦、萘普生钠或无治疗在急性或预防性治疗周末偏头痛中的疗效进行了测试。
28 名(平均年龄 36±12 岁,包括 18 名女性)无先兆偏头痛患者连续 6 个周末进行随访。前两个周末不给予任何治疗。在第三个和第四个周末,患者给予曲普坦 2.5mg,第五个和第六个周末给予萘普生钠 500mg。治疗于星期六和星期天早上进行,无论偏头痛是否发生。通过日记评估疗效,患者根据偏头痛的严重程度(从 0 到 10 分)报告偏头痛的严重程度,并报告使用急救药物的情况。
与萘普生钠(5.7 [95%置信区间(CI)5.1-6.4],P<0.05 与曲普坦)或无治疗(6.6 [6.2-7.0],P<0.01 与曲普坦)相比,曲普坦的偏头痛严重程度评分显著降低(4.8 [95% CI 3.8-5.9])。在未使用急救药物的患者中(曲普坦,1.9 [1.5-2.3])与萘普生钠(3.6 [3.0-4.2],P<0.001)和无治疗(5.1 [4.4-5.8],P<0.001)相比,曲普坦的优势更为明显,并且在治疗的第二天。与萘普生钠(31.3%)或无治疗(56.3%)相比,使用急救药物的比率显著(P<0.05)降低。
本初步研究首次提供了第二代曲坦作为周末偏头痛对症或预防性治疗的疗效证据。