IF 5 2区 医学 Q1 CLINICAL NEUROLOGY
Simona Sacco, Messoud Ashina, Hans-Christoph Diener, Faraidoon Haghdoost, Mi Ji Lee, Teshamae S Monteith, Bronwyn Jenkins, Mario F P Peres, Patricia Pozo-Rosich, Raffaele Ornello, Francesca Puledda, Fumihiko Sakai, Todd J Schwedt, Gisela Terwindt, Gloria Vaghi, Shuu-Jiun Wang, Fayyaz Ahmed, Cristina Tassorelli
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引用次数: 0

摘要

偏头痛是发病率最高、致残率最高的神经系统疾病之一,严重影响生活质量和工作效率,并造成巨大的社会成本。最近的创新药物,包括降钙素基因相关肽(CGRP)通路抑制剂和onabotulinumtoxinA,改变了偏头痛的预防方法,具有很高的疗效和很好的耐受性,从而提高了患者的依从性。临床试验和实际研究表明,偏头痛的发生频率显著降低,在某些情况下甚至可以完全摆脱偏头痛。在本立场声明中,我们主张提高偏头痛预防标准,制定雄心勃勃的治疗目标,以达到最佳治疗效果,如摆脱偏头痛或极低的偏头痛或中度/严重头痛天数。我们强调解决残余偏头痛负担的重要性,并着重指出,每月偏头痛天数减少≥50%虽然通常被认为是成功的应对措施,但可能无法完全恢复生活质量。仅仅依靠基于百分比的改善可能会掩盖残余负担的持续影响。本立场声明无意改变临床试验的标准,而是主要针对现实世界的临床实践,并建议将基于百分比的成功衡量标准转变为治疗期间的绝对目标。我们概述了一个框架,将结果分为四个等级:偏头痛自由度(无偏头痛或中度至重度头痛天数)、最佳控制(偏头痛或中度至重度头痛少于四天)、适度控制(偏头痛或中度至重度头痛四至六天)和控制不足(偏头痛或中度至重度头痛超过天数)。关注治疗过程中的残余负担旨在进一步改善患者的生活质量,推动预防性疗法和非药物疗法的创新。通过倡导更高的标准,本立场声明的主要目的不是推动偏头痛预防性治疗的报销政策,而是激励临床医生、研究人员和政策制定者优先考虑偏头痛预防方面的宏伟目标,最终提高患者的治疗效果,减少这种使人衰弱的疾病对社会和经济造成的广泛影响。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Setting higher standards for migraine prevention: A position statement of the International Headache Society.

Migraine is one of the most prevalent and disabling neurological diseases, significantly affecting quality of life and productivity, as well as contributing to substantial societal costs. Recent innovations, including calcitonin gene-related peptide (CGRP) pathway inhibitors and onabotulinumtoxinA, have transformed migraine prevention by offering high efficacy and excellent tolerability, thus improving adherence. Clinical trials and real-world studies show that significant reductions in migraine frequency and, in some cases, complete migraine freedom is achievable. In this Position Statement, we advocate for raising the standards of migraine prevention by setting ambitious treatment goals aimed at optimal outcomes, such as migraine freedom or very low number of days with migraine or moderate/severe headache. We emphasize the importance of addressing residual migraine burden, highlighting that achieving a ≥50% reduction in monthly migraine days, although often considered a successful response, may not fully restore quality of life. Relying solely on percentage-based improvements can obscure the persisting impact of residual burden. This Position Statement does not want to change the standards for clinical trials but aims primarily at real-world clinical practice and proposes a shift from percentage-based measures of success to absolute goals while on treatment. We outline a framework that categorizes outcomes into four tiers: migraine freedom (no days with migraine or moderate-to-severe headache), optimal control (less than four days with migraine or moderate-to-severe headache), modest control (four to six days with migraine or moderate-to-severe headache) and insufficient control (more than days with migraine or moderate-to-severe headache). Focusing on residual burden while on treatment aims to further improve patient quality of life and drive innovation in preventive therapies and non-pharmacological approaches. By advocating for higher standards, this Position Statement, is not aimed primarily to drive reimbursement policies for migraine preventive treatments, but seeks to inspire clinicians, researchers and policymakers to prioritize ambitious goals in migraine prevention, ultimately enhancing patient outcomes and reducing the broader societal and economic impact of this debilitating condition.

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来源期刊
Cephalalgia
Cephalalgia 医学-临床神经学
CiteScore
10.10
自引率
6.10%
发文量
108
审稿时长
4-8 weeks
期刊介绍: Cephalalgia contains original peer reviewed papers on all aspects of headache. The journal provides an international forum for original research papers, review articles and short communications. Published monthly on behalf of the International Headache Society, Cephalalgia''s rapid review averages 5 ½ weeks from author submission to first decision.
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