Division of Headache, Department of Neurology and Neurological Sciences, Stanford University, 211 Quarry Road, Suite #206, Palo Alto, CA, 94304, USA.
Curr Pain Headache Rep. 2023 Oct;27(10):571-577. doi: 10.1007/s11916-023-01155-w. Epub 2023 Aug 5.
This review examines recent evidence and applies bioethical principles to evaluate the benefits and risks of using step therapy in the treatment of migraine.
With the CGRP mAbs, gepants, and lasmiditan now on the market for up to 5 years, new research, including network meta-analyses and long-term use studies, can evaluate the comparative efficacy, tolerability, and adherence of these medications relative to older acute and preventive medications for the treatment of migraine. Deciding how medications are chosen for patients requires accounting for many factors including sustainability, efficacy, tolerability, and preference. Newer research can help give clarity on the appropriateness of gating certain treatment options behind others.
本文回顾了最新证据，并应用生命伦理原则来评估在偏头痛治疗中使用阶梯疗法的获益与风险。
随着 CGRP mAbs、 gepants 和 lasmiditan 上市至今已达 5 年，新的研究，包括网络荟萃分析和长期使用研究，可以评估这些药物相对于偏头痛治疗的旧的急性和预防性药物的相对疗效、耐受性和依从性。决定为患者选择哪些药物需要考虑许多因素，包括可持续性、疗效、耐受性和偏好。新的研究可以帮助澄清将某些治疗选择置于其他治疗选择之后的合理性。
