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口服天麻素治疗药物过量使用性头痛的疗效和耐受性(EASTERN):一项多中心随机双盲安慰剂对照试验的研究方案

Efficacy and tolerability of oral gastrodin for medication overuse headache (EASTERN): Study protocol for a multicenter randomized double-blind placebo-controlled trial.

作者信息

Kong Fanyi, Buse Dawn C, Geng Jia, Xu Jingjing, Liu Hanxiang, Ma Shu

机构信息

Department of Neurology, The Affiliated Hospital of Yunnan University, Kunming, Yunnan, China.

Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, United States.

出版信息

Front Neurol. 2023 Feb 22;13:1095298. doi: 10.3389/fneur.2022.1095298. eCollection 2022.

Abstract

BACKGROUND

Prophylactic medication in clinical detoxification programs for the treatment of medication overuse headache is still debated. Gastrodin, a main bioactive constituent of , has been applied clinically to treat primary headache for more than 30 years in China due to its potential analgesic and anti-migraine mechanisms. However, clinical evidence supporting its routing use in MOH is insufficient. The present study aims to investigate the efficacy and tolerability of oral gastrodin in medication overuse headache.

METHODS

A multicenter, randomized, double-blind, parallel, placebo-controlled trial will be performed. A target sample size of 186 patients who fulfill the International Classification of Headache Disorders 3rd version (ICHD-3) criteria for MOH will be recruited and screened during a baseline screening period of 28 days before being randomly assigned to either the gastrodin or placebo group at a ratio of 1:1. Enrolled patients will be assessed for each 4 weeks during the 12-weeks double-blind phase and followed up at week 24. The primary endpoint is mean change in monthly headache day frequency. Secondary endpoints will be the proportion of remitted MOH, change in headache pain intensity, headache impact test (HIT-6) score, 50% responder rate, treatment failure, monthly acute medication intake days, and Short Form 36-Item Health Survey (SF-36) score. Tolerability will be assessed by drop-out rates though safety monitoring during treatment.

DISCUSSION

The findings of the present study may help to provide new evidence on gastrodin as a prophylaxis treatment with both efficacy and high tolerability for the treatment of MOH.

CLINICAL TRAIL REGISTRATION

Chinese Clinical Trail Registry (ChiCTR2200063719), Protocol Version 1.1, May, 09, 2022.

摘要

背景

在药物过量使用性头痛的临床解毒方案中,预防性用药仍存在争议。天麻素是天麻的主要生物活性成分,由于其潜在的镇痛和抗偏头痛机制,在中国已临床应用于治疗原发性头痛30多年。然而,支持其在药物过量使用性头痛中常规使用的临床证据不足。本研究旨在探讨口服天麻素治疗药物过量使用性头痛的疗效和耐受性。

方法

将进行一项多中心、随机、双盲、平行、安慰剂对照试验。在28天的基线筛查期内,将招募并筛选186例符合国际头痛疾病分类第3版(ICHD-3)药物过量使用性头痛标准的患者,然后以1:1的比例随机分配到天麻素组或安慰剂组。入组患者将在12周的双盲期内每4周进行一次评估,并在第24周进行随访。主要终点是每月头痛天数的平均变化。次要终点将包括药物过量使用性头痛缓解的比例、头痛疼痛强度的变化、头痛影响测试(HIT-6)评分、50%缓解率、治疗失败、每月急性药物摄入天数以及36项简短健康调查(SF-36)评分。将通过治疗期间的安全监测,以脱落率评估耐受性。

讨论

本研究的结果可能有助于为天麻素作为一种对药物过量使用性头痛具有疗效和高耐受性的预防性治疗提供新的证据。

临床试验注册

中国临床试验注册中心(ChiCTR2200063719),方案版本1.1,2022年5月9日。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/536e/9993247/11a5c26af9cf/fneur-13-1095298-g0001.jpg

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