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偏头痛、曲普坦类药物与酒渣鼻发病风险:英国人群研究

Migraine, triptans, and the risk of developing rosacea: a population-based study within the United Kingdom.

机构信息

Basel Pharmacoepidemiology Unit, Division of Clinical Pharmacy and Epidemiology, Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland.

出版信息

J Am Acad Dermatol. 2013 Sep;69(3):399-406. doi: 10.1016/j.jaad.2013.03.027. Epub 2013 May 1.

Abstract

BACKGROUND

Rosacea is a common skin disease, involving neurogenic inflammation and neurovascular dysregulation. Migraine has been associated with vascular changes and sterile inflammation. The 2 diseases have been associated over decades, but evidence is scarce. Triptans have vasoconstricting and antiinflammatory properties, but a potential impact of this drug class on rosacea remains uninvestigated.

OBJECTIVE

We sought to analyze the association between migraine or triptan exposure and the risk of developing rosacea within the United Kingdom.

METHODS

We conducted a case-control study using the United Kingdom-based General Practice Research Database. We identified patients with incident rosacea between 1995 and 2009 (cases), and matched 1 rosacea-free control subject to each case. We compared the prevalence of diagnosed migraine and exposure to triptans before the first-time rosacea diagnosis between cases and controls using multivariate conditional logistic regression.

RESULTS

Among 53,927 cases and 53,927 controls, we observed a small overall association between rosacea and migraine in women (adjusted odds ratio 1.22, 95% confidence interval 1.16-1.29), but not in men. This effect was somewhat more distinct in female migraineurs aged 50 to 59 years (odds ratio 1.36, 95% confidence interval 1.21-1.53). Female triptan users also revealed slightly increasing risk estimates with increasing age, with the highest odds ratio of 1.66 (95% confidence interval 1.30-2.10) in women aged 60 years or older.

LIMITATIONS

This is a retrospective case-control study, for which a certain degree of bias and confounding cannot be ruled out.

CONCLUSIONS

We observed a slightly increased risk for female migraineurs to develop rosacea, particularly in women with severe migraine aged 50 years or older.

摘要

背景

酒渣鼻是一种常见的皮肤疾病,涉及到神经性炎症和神经血管调节异常。偏头痛与血管变化和无菌性炎症有关。这两种疾病几十年来一直有关联,但证据很少。曲坦类药物具有血管收缩和抗炎作用,但这种药物类别对酒渣鼻的潜在影响尚未得到研究。

目的

我们试图分析英国偏头痛或曲坦类药物暴露与酒渣鼻发病风险之间的关系。

方法

我们进行了一项病例对照研究,使用了英国的一般实践研究数据库。我们在 1995 年至 2009 年期间确定了患有酒渣鼻的患者(病例),并为每个病例匹配了 1 名无酒渣鼻的对照者。我们使用多变量条件逻辑回归比较了病例和对照者在首次酒渣鼻诊断前确诊偏头痛和曲坦类药物暴露的患病率。

结果

在 53927 例病例和 53927 例对照者中,我们观察到女性酒渣鼻与偏头痛之间存在总体上的小关联(调整后的优势比 1.22,95%置信区间 1.16-1.29),但在男性中则不然。在 50 至 59 岁的女性偏头痛患者中,这种影响更为明显(优势比 1.36,95%置信区间 1.21-1.53)。女性曲坦类药物使用者也随着年龄的增长呈现出略微增加的风险估计值,年龄在 60 岁或以上的女性的最高优势比为 1.66(95%置信区间 1.30-2.10)。

局限性

这是一项回顾性病例对照研究,因此不能排除一定程度的偏倚和混杂因素。

结论

我们观察到女性偏头痛患者发生酒渣鼻的风险略有增加,特别是年龄在 50 岁或以上的严重偏头痛女性。

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