Ahmed Fayyaz, Zafar Hassan W, Buture Alina, Khalil Modar
Department of Neurology, Hull Royal Infirmary, Anlaby Road, Hull, HU3 2JZ UK.
Springerplus. 2015 Oct 9;4:589. doi: 10.1186/s40064-015-1386-8. eCollection 2015.
Chronic migraine affects 2 % of the population and has substantial impact on quality of life and considerable burden on healthcare resources. 50-80 % patients with chronic migraine have excessive consumption of analgesic medications. Withdrawal of analgesics is often advised before commencing preventive treatments. However, some headache experts recommend preventive treatments alongside analgesic withdrawal. 434 patients with chronic migraine attending the Hull Headache Clinic who received OnabotulinumtoxinA as preventive treatment were stratified to those with or without analgesic overuse. Data was collected through a dedicated headache diary and analysed for headache and migraine days reduction and for an increment in headache-free days in the month post treatment. The data shows no difference in the therapeutic outcome in patients with or without analgesic overuse with substantial reduction in headache and migraine days and an increment in headache-free days in both groups in a real-life clinical setting. OnabotulinumtoxinA is equally effective in patients with chronic migraine with or without analgesic overuse.
慢性偏头痛影响2%的人口，对生活质量有重大影响，并给医疗资源带来相当大的负担。50%-80%的慢性偏头痛患者过度使用止痛药物。在开始预防性治疗前，通常建议停用止痛药物。然而，一些头痛专家建议在停用止痛药物的同时进行预防性治疗。在赫尔头痛诊所接受A型肉毒毒素作为预防性治疗的434例慢性偏头痛患者，被分为有或没有止痛药物过度使用的两组。通过专门的头痛日记收集数据，并分析治疗后一个月内头痛和偏头痛天数的减少情况以及无头痛天数的增加情况。数据显示，在现实临床环境中，有或没有止痛药物过度使用的患者在治疗效果上没有差异，两组的头痛和偏头痛天数均大幅减少，无头痛天数均增加。A型肉毒毒素对有或没有止痛药物过度使用的慢性偏头痛患者同样有效。
