Lucca Moreira Lopes, Artur Menegaz de Almeida, Eric Pasqualotto, Renan Yuji Ura Sudo, Marianna Gerardo Hidalgo Santos Jorge Leite, Maria Eduarda Cavalcanti Souza, Francisco Cezar Aquino de Moraes, Victória Morbach Siebel, Nathália Figueiredo
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引用次数: 0
摘要
综述目的阿托格潘等降钙素基因相关肽（CGRP）通路调节剂是治疗偏头痛的一种新型疗法。我们进行了一项系统综述和荟萃分析，评估了偏头痛患者使用阿托吉潘与安慰剂进行为期 12 周治疗的效果。与安慰剂相比，阿托格潘显著减少了每月偏头痛天数（WMD -1.27; 95% CI -1.71,-0.83; p <0.01）、急性用药天数（WMD -1.49; 95% CI -1.96,-1.02; p <0.01）和每月头痛天数（WMD -1.53; 95% CI -1.90,-1.15; p <0.01）。在对这些结果进行的亚组分析中，各组的总体结果相似。阿托吉潘治疗组的恶心（RR 2.23；95% CI 1.43，3.48；p <；0.01）和便秘（RR 3.57；95% CI 1.62，7.89；p <；0.01）明显增加。总结这项RCT荟萃分析表明，阿托格潘可有效减少偏头痛患者的偏头痛发作，但与安慰剂相比，阿托格潘可增加恶心和便秘的发生率。
Efficacy and Safety of Atogepant for Preventing Chronic and Episodic Migraines: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Purpose of Review
Calcitonin gene-related peptide (CGRP) pathway modulators, such as atogepant, represent a novel therapeutic option for the treatment of migraines. We performed a systematic review and meta-analysis to evaluate the effects of 12-week treatment with atogepant compared with placebo in patients with migraine.
Recent Findings
A total of four RCTs and 3,140 patients were included, of whom 2,306 were prescribed atogepant. Compared with placebo, atogepant significantly reduced monthly migraine days (WMD -1.27; 95% CI -1.71,-0.83; p < 0.01), days with acute medication use (WMD -1.49; 95% CI -1.96,-1.02; p < 0.01), and monthly headache days (WMD -1.53; 95% CI -1.90,-1.15; p < 0.01). In the subgroup analysis of those outcomes, overall results were similar between groups. There was a significant increase in nausea (RR 2.23; 95% CI 1.43, 3.48; p < 0.01) and constipation (RR 3.57; 95% CI 1.62, 7.89; p < 0.01) in the atogepant-treated group. There were no significant differences in nasopharyngitis, upper airway infection, urinary tract infection, fatigue, serious adverse events, and discontinuation of treatment due to adverse events.
Summary
This meta-analysis of RCTs suggests that atogepant is effective in the reduction of migraine episodes among patients with migraine headaches, albeit with an increase in nausea and constipation relative to placebo.
期刊介绍：
This journal aims to review the most important, recently published treatment option advances in the field of neurology. By presenting clear, insightful, balanced contributions by international experts, the journal intends to facilitate worldwide approaches to the treatment of neurologic conditions.
We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas, such as epilepsy, headache, neurologic ophthalmology and otology, neuromuscular disorders, psychiatric manifestations of neurologic disease, and sleep disorders. Section Editors select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. We also provide commentaries from well-known neurologists, and an international Editorial Board reviews the annual table of contents, suggests articles of special interest to their country/region, and ensures that topics are current and include emerging research.
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