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Headache:拉米替坦口服治疗偏头痛的急性发作后的疗效

2020-03-14 MedSci原创 MedSci原创

拉米替坦是一种缺乏血管收缩活性的新型选择性5-羟色胺1F受体激动剂。本研究旨在扩展有关口服拉米替坦对偏头痛急性治疗疗效的可用信息,尤其要关注其作用时机及其对偏头痛相关症状的影响。在2项3期研究中,SA

拉米替坦是一种缺乏血管收缩活性的新型选择性5-羟色胺1F受体激动剂。本研究旨在扩展有关口服拉米替坦对偏头痛急性治疗疗效的可用信息,尤其要关注其作用时机及其对偏头痛相关症状的影响。在2项3期研究中,SAMURAI和SPARTAN中的拉米替坦在初始剂量后2小时达到了主要和次要疗效终点。

 

SPARTAN和SAMURAI这2个3期临床试验完成综合分析。基线和服用拉米替坦(50、100或200 mg)或安慰剂后每30分钟收集一次数据进行分析,以确定疗效的开始。总共5236名患者随机分配接受安慰剂(N = 1493),拉米替坦50 mg(N = 750),拉米替坦100 mg(N = 1498)或拉米替坦200 mg(N = 1495)治疗。分析数据以确定以下疗效指标的改善开始:无疼痛,无困扰症状,疼痛缓解,无相关症状(畏光,恐惧心理或恶心),无偏头痛(定义为无疼痛和消除相关症状),以及无偏头痛相关的功能障碍。研究还分析了达到有意义的头痛缓解时间和首次变得无痛的时间。

 

结果显示,与安慰剂组相比,在100和200 mg的拉米坦治疗组中,从60分钟时开始,无痛(100 mg,10.0%,P = .012;200 mg,15.5%,P <.001;安慰剂,7.0%)和无偏头痛(100 mg,8.9%,P = .017;200 mg,12.4%,P <.001;安慰剂,6.1%)的缓解率显著提高。接受拉米替坦100和200 mg拉米替坦治疗的组中,最早在30分钟之内就开始无​​症状困扰的缓解率(100 mg,11.1%,P = .015; 200 mg,13.0%,P <.001;安慰剂,7.9%)和疼痛缓解率(100 mg,17.5%,P = .007;200 mg,19.1%,P <.001;安慰剂,13.4%)就已显著提高。开始使用200 mg 拉米替坦治疗组的患者中,从30分钟开始,无畏光(13.7%,P = .005;安慰剂,9.2%)和恐惧(17.4%,P = .042;安慰剂,13.4%)的患者百分比显著提高。从60分钟开始,在接受200 mg拉米替坦治疗的患者中,有更大比例的患者摆脱了与偏头痛相关的功能障碍(16.4%,P <.001;安慰剂,11.1%)。除了无恶心之外,在90和120分钟时,与安慰剂相比,拉米替坦治疗(50、100或200 mg)的所有功效指标均具有统计学意义。最后,与服用安慰剂的患者相比,服用拉米替坦的患者在24小时内更有可能实现有意义的头痛缓解并变得无头痛(P <.001)。

 

总之,与接受安慰剂治疗的患者相比,接受拉米替坦治疗的偏头痛发作患者的起效时间更早。缓解疼痛之类的某些功效措施最早在100或200 mg拉米替坦治疗后30分钟首次评估时就得到了改善。

 

原始出处:

 

Messoud AshinaRaghavendra Vasudeva, et al., Onset of Efficacy Following Oral Treatment With Lasmiditan for the Acute Treatment of Migraine: Integrated Results From 2 Randomized Double-Blind Placebo-Controlled Phase 3 Clinical Studies. Headache. 2019 Nov-Dec; 59(10): 1788–1801. doi: 10.1111/head.13636

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    2020-03-16 般若傻瓜
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  3. [GetPortalCommentsPageByObjectIdResponse(id=1264737, encodeId=94771264e37f6, content=<a href='/topic/show?id=150f19229c' target=_blank style='color:#2F92EE;'>#ADA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1922, encryptionId=150f19229c, topicName=ADA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ad9f79, createdName=般若傻瓜, createdTime=Mon Mar 16 08:56:29 CST 2020, time=2020-03-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1554322, encodeId=87d215543225a, content=<a href='/topic/show?id=8402522319e' target=_blank style='color:#2F92EE;'>#急性发作#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=52231, encryptionId=8402522319e, topicName=急性发作)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=287314518946, createdName=anminleiryan, createdTime=Mon Mar 16 08:56:29 CST 2020, time=2020-03-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1032442, encodeId=f2f51032442c4, content=谢谢梅斯提供这么好的信息,学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=内科新手, createdTime=Sat Mar 14 20:56:29 CST 2020, time=2020-03-14, status=1, ipAttribution=)]
    2020-03-14 内科新手

    谢谢梅斯提供这么好的信息,学到很多

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