Institute for Medical Informatics, Biometry and Epidemiology, Medical Faculty of the University of Duisburg-Essen, Essen, Germany.
Migraine and Headache Clinic Koenigstein, Koenigstein, Germany.
Eur J Neurol. 2022 Jan;29(1):350-357. doi: 10.1111/ene.15103. Epub 2021 Sep 28.
Many migraine patients rely on over-the-counter analgesics for the treatment of migraine attacks. Fixed-dose combinations of aspirin, paracetamol and caffeine (APC) have been used for treating migraine in many countries for a long time. We performed a meta-analysis for the comparison of APC versus placebo, which has not been done to date.
Randomized, blinded, placebo-controlled, parallel-group studies using APC to treat a migraine attack were included in a meta-analysis. We calculated the rate ratio (RRs) associated with APC versus placebo.
Seven studies were included, with 3306 participants (2147 treated with APC and 1159 treated with placebo). For the primary efficacy outcome, being pain-free at 2 h, APC was superior to placebo (19.6% vs. 9.0%, RR 2.2, 95% confidence interval [CI] 1.4-3.3). For the co-primary efficacy outcome, pain relief at 2 h, APC was superior to placebo (54.3% vs. 31.2%, RR 1.7, 95% CI 1.6-1.9). Adverse events were more frequent in the APC than the placebo groups (10.9% vs. 7.8%, RR 1.7, 95% CI 1.3-2.2).
Results showed that APC is superior to placebo in the treatment of acute migraine attacks. Efficacy, measured by pain-free response and pain relief at 2 h, was clinically relevant.
许多偏头痛患者依赖非处方镇痛药来治疗偏头痛发作。在许多国家，阿司匹林、对乙酰氨基酚和咖啡因的固定剂量组合（APC）已长期用于治疗偏头痛。我们进行了一项针对 APC 与安慰剂的荟萃分析，迄今为止尚未进行过此类分析。
纳入使用 APC 治疗偏头痛发作的随机、双盲、安慰剂对照、平行组研究，我们计算了 APC 与安慰剂相关的率比（RR）。
纳入了 7 项研究，共有 3306 名参与者（2147 名接受 APC 治疗，1159 名接受安慰剂治疗）。对于主要疗效结局，2 小时无痛率，APC 优于安慰剂（19.6%比 9.0%，RR 2.2，95%置信区间[CI] 1.4-3.3）。对于主要次要疗效结局，2 小时疼痛缓解率，APC 优于安慰剂（54.3%比 31.2%，RR 1.7，95% CI 1.6-1.9）。APC 组不良事件发生率高于安慰剂组（10.9%比 7.8%，RR 1.7，95% CI 1.3-2.2）。
结果表明，APC 在治疗急性偏头痛发作方面优于安慰剂。以 2 小时无痛和疼痛缓解率衡量的疗效具有临床意义。
