Ehret Christopher J, Martin Nichole, Jatoi Aminah
Department of Oncology, Mayo Clinic, Rochester, Minnesota, USA.
Department of Oncology, Mayo Clinic, Rochester, Minnesota, USA
BMJ Support Palliat Care. 2024 Jan 8;13(e3):e1405-e1408. doi: 10.1136/spcare-2022-003764.
Hiccups can be bothersome and spawn morbidity. Although oral baclofen is perhaps the most prescribed agent for hiccups, a paucity of data supports its use.
This multisite, single institution study examined the medical records of patients who had hiccups and had been prescribed baclofenas noted in a clinical encounter. Mixed methods were used to assess baclofen's palliative efficacy. In view of the sometimes transient nature of hiccups and other such factors, cessation or palliation of hiccups in 75% of patients was sought to indicate true palliation.
A total of 301 patients with a median age of 61 years (range 20-87 years) and a male predominance are the focus of this report. Baclofen was most often prescribed at 10 mg orally three times a day. Only 105 patients (35%) (95% CI: 30% to 41%) acquired hiccup palliation. Corroborative medical record quotations included, 'Still has hiccups.'Quotations such as, 'Responding to baclofen this AM', were also recorded. Baclofen appeared more likely to benefit patients with hiccups of >48 hours (chronic) duration in univariable analyses (OR for benefit: 0.51 (95% CI: 0.29 to 0.91; p=0.02) with similar conclusions drawn from multivariable analyses. Adverse events occurred in 15 patients with drowsiness the most common.
Baclofen did not meet this study's a priori threshold for successful hiccup palliation, but further study is indicated to learn whether baclofen might help patients with chronic hiccups.
呃逆可能令人烦恼并引发疾病。尽管口服巴氯芬可能是治疗呃逆最常用的药物，但支持其使用的数据却很少。
这项多中心、单机构研究检查了在临床会诊中被记录为患有呃逆且已开具巴氯芬处方的患者的病历。采用混合方法评估巴氯芬的缓解疗效。鉴于呃逆有时具有短暂性以及其他此类因素，旨在使75%的患者呃逆停止或缓解以表明真正的缓解效果。
本报告聚焦于301例患者，中位年龄为61岁（范围20 - 87岁），男性居多。巴氯芬最常的处方剂量是每日口服3次，每次10毫克。只有105例患者（35%）（95%置信区间：30%至41%）呃逆得到缓解。病历中的佐证性记录包括“仍有呃逆”。也记录了诸如“今晨对巴氯芬有反应”之类的记录。单变量分析显示，巴氯芬似乎更有可能使呃逆持续时间>48小时（慢性）的患者受益（获益的比值比：0.51（95%置信区间：0.29至0.91；p = 0.02）），多变量分析也得出了类似结论。15例患者出现不良事件，最常见的是嗜睡。
巴氯芬未达到本研究中呃逆成功缓解的先验阈值，但表明需要进一步研究以了解巴氯芬是否可能有助于治疗慢性呃逆患者。
