Iannone Luigi Francesco, De Cesaris Francesco, Geppetti Pierangelo
Section of Clinical Pharmacology and Oncology, Department of Health Sciences, University of Florence, 50121 Florence, Italy.
Headache Center and Clinical Pharmacology Unit, Careggi University Hospital, 50134 Florence, Italy.
Life (Basel). 2022 Apr 5;12(4):536. doi: 10.3390/life12040536.
Headaches in children and adolescents have high incidence and prevalence rates, with consequent elevated disability costs to individuals and the community. Pediatric migraine is a disorder with substantial clinical differences compared to the adult form. Few clinical trials have been performed specifically on primary headache in pediatric populations using acute and preventative treatments, often with conflicting findings. The limited high-quality data on the effectiveness of treatments are also due to the high placebo effect, in terms of reductions in both the frequency and intensity of migraine attacks in the pediatric population. The recent introduction of calcitonin gene-related peptide (CGRP) pathway inhibitors and ditans is changing the treatment of migraine, but the majority of the data are still limited to adulthood. Thus, few drugs have indications for migraine treatment in the pediatric age group, and limited evidence gives guidance as to the choice of pharmacotherapy. Herein, we review the current evidence of pharmacological treatments and ongoing clinical trials on acute and preventative treatments in the pediatric population with migraine.
儿童和青少年头痛的发病率和患病率很高,给个人和社区带来了高昂的残疾成本。小儿偏头痛是一种与成人形式有显著临床差异的疾病。很少有专门针对小儿原发性头痛使用急性和预防性治疗的临床试验,结果往往相互矛盾。关于治疗效果的高质量数据有限,也是由于小儿人群偏头痛发作频率和强度降低方面存在较高的安慰剂效应。降钙素基因相关肽(CGRP)通路抑制剂和双靶点药物的近期引入正在改变偏头痛的治疗,但大多数数据仍限于成人。因此,很少有药物适用于小儿年龄组的偏头痛治疗,关于药物治疗选择的证据也很有限。在此,我们综述了小儿偏头痛人群急性和预防性治疗的药物治疗现有证据及正在进行的临床试验。