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捷克共和国偏头痛患病率及其预防性治疗模式的调查:一项观察性研究。

An Investigation into the Prevalence of Migraine and Its Prophylactic Treatment Patterns in the Czech Republic: An Observational Study.

作者信息

Dolezil David, Markova Jolana, Klimes Jiri, Pocikova Zuzana, Dostal Filip, Stepanova Radka, Svobodnik Adam

机构信息

Prague Headache Center, DADO MEDICAL s.r.o., Prague, Czech Republic.

University Thomayer Hospital, Prague, Czech Republic.

出版信息

J Pain Res. 2020 Nov 12;13:2895-2906. doi: 10.2147/JPR.S273119. eCollection 2020.

Abstract

PURPOSE

A national primary and secondary healthcare-level study in the Czech Republic has not yet been conducted to evaluate the prevalence of migraine. We analyzed the current treatment patterns (acute and prophylactic) in migraine patients and the number of migraine patients potentially eligible for treatment with recent calcitonin gene-related peptide (CGRP) pathway-targeted therapies.

METHODS

This retrospective study utilized the Ministry of the Interior Health Insurance Fund claims database of the Czech Republic wherein every citizen is insured. Migraine patients with or without aura, and potentially on triptan therapy were included in this study (index years 2012-2016). The prevalence approach included all patients (new and old) present in each index year. Prophylactic therapies were followed f0or three and seven years prior to the index year, including the index year, until 2010. The incidence approach included all patients first diagnosed in each index year. Prophylactic therapies were followed for the next three years, including the index year, until 2017 following incidence approach. The primary endpoint of this study was to determine the rate of migraine prevalence and diagnosis for each index year during the period 2012-2016. The study also evaluated prophylactic and acute treatment patterns and comorbidities among patients in 2016.

RESULTS

The rate of migraine prevalence was 1% and the rate of diagnosis was 0.2-0.4%. By prevalence approach, approximately 39% of the patients were on prophylactics, and 11.2% and 21.6% of the patient population had two prior treatment failures (three- and seven-year recall period, respectively). Antiepileptics (26%) and beta blockers (15.8%) were the most prescribed prophylactics, and sumatriptan was the predominant triptan used (12%) for acute treatment.

CONCLUSION

Taking into account the number of inhabitants in the Czech Republic (10.7 million), there could be up to 23,000 adult patients eligible for novel CGRP therapies.

摘要

目的

捷克共和国尚未开展一项全国性的基层医疗保健层面的研究来评估偏头痛的患病率。我们分析了偏头痛患者当前的治疗模式(急性治疗和预防性治疗)以及可能适合使用近期降钙素基因相关肽(CGRP)通路靶向疗法进行治疗的偏头痛患者数量。

方法

这项回顾性研究利用了捷克共和国内政部健康保险基金理赔数据库,该国每位公民均参保。本研究纳入了有或无先兆且可能正在接受曲坦类药物治疗的偏头痛患者(索引年份为2012 - 2016年)。患病率计算方法纳入了每个索引年份中的所有患者(新患者和老患者)。预防性治疗在索引年份之前的三年和七年进行跟踪,包括索引年份,直至2010年。发病率计算方法纳入了每个索引年份首次诊断的所有患者。按照发病率计算方法,在发病后对预防性治疗进行接下来三年的跟踪,包括索引年份,直至2017年。本研究的主要终点是确定2012 - 2016年期间每个索引年份的偏头痛患病率和诊断率。该研究还评估了2016年患者的预防性和急性治疗模式以及合并症。

结果

偏头痛患病率为1%,诊断率为0.2 - 0.4%。按照患病率计算方法,约39%的患者正在接受预防性治疗,11.2%和21.6%的患者人群分别在之前有两次治疗失败(三年和七年回顾期)。抗癫痫药物(26%)和β受体阻滞剂(15.8%)是最常开具的预防性药物,舒马曲坦是急性治疗中使用的主要曲坦类药物(12%)。

结论

考虑到捷克共和国的居民数量(1070万),可能有多达23000名成年患者适合使用新型CGRP疗法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5d11/7669514/77afbd8d3aaf/JPR-13-2895-g0001.jpg

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