丛集性头痛对舒马曲坦无反应：一项回顾性研究。

Cluster headache not responsive to sumatriptan: A retrospective study.

机构信息

Neuroalgology Unit, Fondazione IRCCS Istituto Neurologico "Carlo Besta", Milan, Italy.

Department of Biomedical and Clinical Sciences "Luigi Sacco", University of Milan, Milan, Italy.

出版信息

Cephalalgia. 2021 Jan;41(1):117-121. doi: 10.1177/0333102420956705. Epub 2020 Sep 3.

DOI:10.1177/0333102420956705

PMID:32883087

Abstract

INTRODUCTION

Subcutaneous sumatriptan, a 5HT agonist, is the most effective drug in cluster headache acute treatment. About 25% of the patients do not respond to subcutaneous sumatriptan; the reasons for this are unknown. In this study, we compare clinical characteristics of cluster headache patients responding and non-responding to subcutaneous sumatriptan.

METHODS

We retrospectively investigated the clinical records of 277 cluster headache patients. Patients reporting repeated satisfactory response to subcutaneous sumatriptan within 15 minutes were considered responders.

RESULTS

Of 206 cluster headache patients who had used subcutaneous sumatriptan (mean age 45.6, 16% females, 48% chronic), 91% were responders, and 9% non-responders. Compared to responders, non-responders had longer and more frequent attacks: 60 (median; IQR 38-90) vs. 100 (60-120) minutes ( = 0.028), 4 (2.5-5) vs. 3 (2-4) attacks/day ( = 0.024). No other difference was found.

CONCLUSIONS

In cluster headache attacks with long duration and high frequency, pain mechanisms not involving 5HT receptors may play a more relevant role.

摘要

简介

皮下舒马曲坦是一种 5HT 激动剂，是治疗丛集性头痛急性发作最有效的药物。约 25%的患者对皮下舒马曲坦无反应；其原因尚不清楚。在这项研究中，我们比较了对皮下舒马曲坦有反应和无反应的丛集性头痛患者的临床特征。

方法

我们回顾性调查了 277 例丛集性头痛患者的临床记录。报告在 15 分钟内皮下舒马曲坦重复满意反应的患者被认为是有反应者。

结果

在 206 例使用皮下舒马曲坦的丛集性头痛患者中（平均年龄 45.6 岁，女性占 16%，慢性患者占 48%），91%为有反应者，9%为无反应者。与有反应者相比，无反应者的发作时间更长、更频繁：60 分钟（中位数；IQR 38-90）比 100 分钟（60-120）（ = 0.028），3 次/天（2-4）发作比 4 次/天（2.5-5）（ = 0.024）。未发现其他差异。