Visser W H, de Vriend R H, Jaspers M W, Ferrari M D
Department of Neurology, University Hospital, Leiden, The Netherlands.
Neurology. 1996 Jul;47(1):46-51. doi: 10.1212/wnl.47.1.46.
The long-term and within-patient consistency of the efficacy and tolerability of subcutaneous and oral sumatriptan in migraine was studied by retrospective survey of 2 years with mailed self-administered questionnaires in our neurology outpatient clinic. Subjects were migraine patients with or without aura (N = 869). We measured long-term use of sumatriptan and within-patient consistency and change over time of headache relief, headache recurrence, and chest symptoms after sumatriptan. The questionnaire was returned by 735 (85%) patients; 453 had used sumatriptan for nearly 28,000 attacks during 25 (median) months (92% > 1 year). Sumatriptan provided headache relief, mostly within 2 hours, in 85% of patients in at least two-thirds of their attacks. Of all patients, 75% experienced (usually multiple) headache recurrences in at least some and 40% in (nearly) all attacks. Median time to recurrence was 8 to 12 hours (range 1 to 30). Recurrence of aura was reported as well. Over 2 years, efficacy of sumatriptan had waned in 18% of patients (mainly because of increase in headache recurrence) and improved in 12% (mainly because of reduction of headache recurrence or adverse events or increase of headache relief); the number of monthly doses of sumatriptan had increased in 20%, reduced in 35%, and not changed in 45% of patients. Chest symptoms occurred in up to 58% of patients in at least some and in up to 42% of patients in all attacks, causing discontinuation of sumatriptan in 10%. In total, 111 patients (25%) discontinued sumatriptan mainly because of headache recurrence, adverse events, insufficient headache relief, or high price. In most patients, the effects of sumatriptan were consistent within subjects and over time. In most patients, sumatriptan provided rapid headache relief. Multiple headache recurrence was the major limitation. Chest symptoms were frequent but usually not serious if patients were forewarned.
在我们的神经内科门诊，通过对2年的回顾性调查，并使用邮寄的自填问卷，研究了皮下注射和口服舒马曲坦治疗偏头痛的疗效和耐受性的长期及患者内一致性。研究对象为有或无先兆的偏头痛患者（N = 869）。我们测量了舒马曲坦的长期使用情况、患者内一致性以及舒马曲坦治疗后头痛缓解、头痛复发和胸部症状随时间的变化。735名（85%）患者返回了问卷；453名患者在25个月（中位数）内使用舒马曲坦治疗了近28,000次发作（92%＞1年）。舒马曲坦在至少三分之二的发作中，能在2小时内使85%的患者头痛缓解。所有患者中，75%至少在部分发作中经历过（通常为多次）头痛复发，40%在（几乎）所有发作中都有复发。复发的中位时间为8至12小时（范围1至30小时）。也有先兆复发的报告。在2年期间，18%的患者舒马曲坦疗效减弱（主要是因为头痛复发增加），12%的患者疗效改善（主要是因为头痛复发减少或不良事件减少或头痛缓解增加）；20%的患者舒马曲坦每月剂量增加，35%的患者减少，45%的患者未改变。至少部分发作中，高达58%的患者出现胸部症状，所有发作中高达42%的患者出现胸部症状，10%的患者因胸部症状停用舒马曲坦。总共111名患者（25%）停用舒马曲坦，主要原因是头痛复发、不良事件、头痛缓解不足或价格高昂。在大多数患者中，舒马曲坦的效果在个体内和随时间是一致的。在大多数患者中，舒马曲坦能迅速缓解头痛。多次头痛复发是主要限制因素。胸部症状很常见，但如果提前告知患者，通常并不严重。
