全国健康与营养调查中抑酸疗法的使用与偏头痛和严重头痛的几率。

IF 2.3 Q3 CLINICAL NEUROLOGY
Neurology. Clinical practice Pub Date : 2024-06-01 Epub Date: 2024-04-24 DOI:10.1212/CPJ.0000000000200302
Margaret Slavin, Cara L Frankenfeld, Alexander B Guirguis, Elizabeth K Seng
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引用次数: 0

摘要

背景和目的:头痛是与使用质子泵抑制剂(PPI)相关的一种不良反应。最近,偏头痛作为使用质子泵抑制剂的一种潜在不良反应而出现。这项工作的目的是利用现有数据评估偏头痛和严重头痛的发生率与抑酸疗法(包括 PPI、H2 受体拮抗剂 (H2RA)、普通抗酸剂)的使用之间的关联;比较 PPI 与 H2RA 的风险;评估受抑酸疗法影响的饮食因素是否可能减轻偏头痛:本横断面分析采用了 1999-2004 年全国健康与营养调查中的成人数据。抑酸疗法的使用情况是通过产品包装审查确认的自我报告。在过去 3 个月中表示有偏头痛或严重头痛的受访者被归入偏头痛或严重头痛组。镁的膳食摄入量是通过一次 24 小时回忆访谈确定的。我们建立了多变量逻辑回归模型来分析抑酸疗法的使用与偏头痛或严重头痛之间的关系,并进行了交互检验,以评估抑酸疗法使用者和非使用者的偏头痛或严重头痛发病率与营养镁摄入量之间是否存在差异:在11818名美国成年人中,与不使用抑酸疗法的人相比,使用所有类型的抑酸疗法和使用任何类型的抑酸疗法的人发生偏头痛或严重头痛的几率都更高:使用PPIs(高70%)、H2RAs(高40%)和普通抗酸剂(高30%)。不同抑酸疗法之间的差异并不显著。使用 H2RA 与镁摄入量之间存在交互作用(p = 0.024):这些在美国成年人中观察到的结果与之前的研究结果一致,即偏头痛或严重头痛是PPIs(最有效、最常用的抑酸药物)的潜在不良事件,并进一步表明其他类别的抑酸药物(H2RAs和普通抗酸剂)也可能与偏头痛和严重头痛有关。未来需要进行前瞻性分析,以研究与抑酸药物相关的偏头痛风险,而目前的证据足以根据最近对PPIs的停药建议对偏头痛患者进行评估。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Use of Acid-Suppression Therapy and Odds of Migraine and Severe Headache in the National Health and Nutrition Examination Survey.

Background and objectives: Headache is an adverse event associated with the use of proton pump inhibitors (PPIs). Recently, migraine has emerged more specifically as a potential adverse event with PPI use. The objectives of this work were to capitalize on existing data to evaluate the association between migraine and severe headache prevalence and use of acid-suppression therapy, including PPIs, H2 receptor antagonists (H2RAs), and generic antacids; to compare risk from PPIs vs H2RAs; and to assess for potential mitigation by a dietary factor affected by acid-suppression therapy.

Methods: Data from adults in the 1999-2004 National Health and Nutrition Examination Survey were used for this cross-sectional analysis. Acid-suppression therapy use was identified from self-report confirmed by product packaging review. Respondents who endorsed migraine or severe headache in the past 3 months were classified in the migraine or severe headache group. Dietary intake of magnesium was determined using one 24-hour recall interview. Multivariable logistic regression models were generated to analyze the relationship between acid-suppression therapy use and migraine or severe headache, and an interaction test was conducted to evaluate whether migraine or severe headache prevalence differed in relation to nutritional magnesium intake across acid-suppression therapy users and nonusers.

Results: In 11,818 US adults, the use of acid-suppression therapy was associated with higher odds of migraine or severe headache for all types of acid-suppression therapy and use of any type, as compared with those who did not use acid-suppression therapy: use of PPIs (70% higher), H2RAs (40% higher), and generic antacids (30% higher). Differences between acid-suppression therapy were not significant. An interaction was observed for H2RA use and magnesium intake (p = 0.024).

Discussion: These observations in US adults agree with previous findings that migraine or severe headache is a potential adverse event of PPIs, the most efficacious and most frequently used type of acid suppressing medication, and further suggest that other classes of acid suppressing medications (H2RAs and generic antacids) may also be implicated for migraine and severe headache. Future prospective analyses are needed to investigate migraine risk associated with acid suppressing medications while current evidence is sufficient to evaluate patients with migraine in light of recent deprescribing advice for PPIs.

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来源期刊
Neurology. Clinical practice
Neurology. Clinical practice CLINICAL NEUROLOGY-
CiteScore
4.00
自引率
0.00%
发文量
77
期刊介绍: Neurology® Genetics is an online open access journal publishing peer-reviewed reports in the field of neurogenetics. The journal publishes original articles in all areas of neurogenetics including rare and common genetic variations, genotype-phenotype correlations, outlier phenotypes as a result of mutations in known disease genes, and genetic variations with a putative link to diseases. Articles include studies reporting on genetic disease risk, pharmacogenomics, and results of gene-based clinical trials (viral, ASO, etc.). Genetically engineered model systems are not a primary focus of Neurology® Genetics, but studies using model systems for treatment trials, including well-powered studies reporting negative results, are welcome.
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