慢性丛集性头痛患者接受吲哚美辛治疗的回顾性观察：105 例病例报告
A retrospective observation on 105 patients with chronic cluster headache receiving indomethacin.
机构信息
Department of Evaluation and Treatment of Pain, FHU INOVPAIN, la Timone Hospital, CHU Timone, AP-HM, Marseille, France.
EA 3279, Public Health, Chronic Diseases and Quality of Life, Research Unit, Aix-Marseille University, Marseille, France.
出版信息
Neurol Sci. 2021 Oct;42(10):4175-4182. doi: 10.1007/s10072-021-05114-4. Epub 2021 Feb 5.
BACKGROUND
Indomethacin (IMC) as a prophylactic treatment is considered to be ineffective in cluster headache (CH). However, small series suggested the interest of IMC in CH. Some authors support that an IMC test is useful in all trigeminal autonomic cephalalgias. We described clinical features of IMC responders in a retrospective cohort of chronic cluster headache (CCH).
METHODS
This single-center and retrospective study was conducted in a tertiary care specialist headache center in France. Patients were selected between January 2007 and December 2008. We included all patients fulfilling CCH criteria (ICHD-3-beta). Data were collected from medical records. We recorded all the prescriptions of IMC as a prophylactic treatment. Responders were defined by 50% reduction in attack frequency; complete response was defined by disappearance of the attacks. The non-responders must have received at least 100 mg daily during 7 days.
RESULTS
The study consisted of 324 CCH, 121 female (37%) and 203 males (63%) with an average age at onset of 33.93 (± 14.71) years. Of the patients, 105 were treated with IMC. Thirty patients (29%) were responders. Thirty-four patients (32%) were non-responders. Responding status was undefined for 41 patients (39%). Twelve patients (11%) had a complete response. Responders were composed by 18 women (60%) and 12 men (40%) and had on average 44.89 (± 12.88) years. The minimal effective dose was 86.11 mg daily (± 48.72).
DISCUSSION
This study shows the interest of IMC in CCH patients. We recommend an IMC test as a third-line treatment in CCH.
背景
吲哚美辛（IMC）作为预防治疗被认为对丛集性头痛（CH）无效。然而，小系列研究表明 IMC 对 CH 有一定疗效。一些作者支持 IMC 试验对所有三叉神经自主头痛均有一定作用。我们描述了在慢性丛集性头痛（CCH）的回顾性队列中 IMC 反应者的临床特征。
方法
本单中心回顾性研究在法国一家三级专科头痛中心进行。患者于 2007 年 1 月至 2008 年 12 月期间入选。我们纳入了所有符合 CCH 标准（ICHD-3-beta）的患者。数据从病历中收集。我们记录了所有作为预防治疗的 IMC 处方。反应者定义为发作频率降低 50%；完全缓解定义为发作消失。无反应者必须每天接受至少 100mg 治疗至少 7 天。
结果
该研究共纳入 324 例 CCH，其中女性 121 例（37%），男性 203 例（63%），平均发病年龄为 33.93（±14.71）岁。105 例患者接受 IMC 治疗。30 例（29%）为反应者。34 例（32%）为无反应者。41 例（39%）的反应状态未定义。12 例（11%）患者完全缓解。反应者由 18 例女性（60%）和 12 例男性（40%）组成，平均年龄为 44.89（±12.88）岁。最小有效剂量为 86.11mg/天（±48.72）。
讨论
本研究表明 IMC 对 CCH 患者有一定疗效。我们建议将 IMC 试验作为 CCH 的三线治疗方法。
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