A型肉毒杆菌毒素治疗原发性新发性每日持续性头痛及其与慢性偏头痛的比较

OnabotulinumtoxinA for primary new daily persistent headache and comparison to chronic migraine.

作者信息

Cheema Sanjay, Lagrata Susie, Rantell Khadija Rerhou, Ahmed Maha, Kamourieh Salwa, Matharu Manjit Singh

机构信息

Headache and Facial Pain Group, University College London Queen Square Institute of Neurology, London, UK.

Headache and Facial Pain Group, The National Hospital for Neurology and Neurosurgery, London, UK.

出版信息

Cephalalgia. 2025 Feb;45(2):3331024251317448. doi: 10.1177/03331024251317448.

DOI:10.1177/03331024251317448

PMID:39924901

Abstract

BACKGROUND

New daily persistent headache (NDPH) is an often treatment-refractory primary headache disorder with a lack of evidence base for treatment.

METHODS

We performed an observational study using prospectively collected data in consecutive patients with NDPH, chronic migraine with daily headache (daily-CM) and without daily headache (non-daily-CM). Patients were treated with two cycles of OnabotulinumtoxinA. Propensity score matching was used to control for imbalances between the groups. The primary outcome measure was the proportion who experienced a ≥ 30% improvement in monthly moderate-to-severe headache days at 24 weeks.

RESULTS

We included 58 patients with NDPH, 148 with daily-CM, and 84 with non-daily-CM. In NDPH, 34.5% of patients experienced a ≥ 30% improvement in monthly moderate-to-severe headache days, compared to 43.2% in daily-CM and 51.2% in non-daily CM. In NDPH, 6.9% experienced an improvement in monthly headache days, 27.6% an improvement in headache severity, 25.9% a ≥ 6 point improvement in HIT-6 score, and 59% a patient reported improvement. There was no significant difference in response rates between the three groups. Adverse event rates were similar in all groups and there were no serious adverse events.

CONCLUSION

OnabotulinumtoxinA is effective in approximately 1/3 patients with NDPH and has a favourable safety profile.

摘要

背景

新发性每日持续性头痛（NDPH）是一种常常难以治疗的原发性头痛疾病，缺乏治疗的证据基础。

方法

我们进行了一项观察性研究，前瞻性收集连续的NDPH患者、每日发作性慢性偏头痛（每日-CM）和非每日发作性慢性偏头痛（非每日-CM）患者的数据。患者接受两个周期的A型肉毒毒素治疗。采用倾向评分匹配来控制组间不平衡。主要结局指标是在24周时每月中重度头痛天数改善≥30%的患者比例。

结果

我们纳入了58例NDPH患者、148例每日-CM患者和84例非每日-CM患者。在NDPH患者中，34.5%的患者每月中重度头痛天数改善≥30%，相比之下，每日-CM患者为43.2%，非每日-CM患者为51.2%。在NDPH患者中，6.9%的患者每月头痛天数有所改善，27.6%的患者头痛严重程度有所改善，25.9%的患者HIT-6评分改善≥6分，59%的患者报告病情有所改善。三组之间的缓解率没有显著差异。所有组的不良事件发生率相似，且没有严重不良事件。