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Мигрень в клинической практике невролога: тернистый путь к рациональной терапии пациентов
Мигрень в клинической практике невролога: тернистый путь к рациональной терапии пациентов
Екушева Е.В., Филатова Е.Г. Мигрень в клинической практике невролога: тернистый путь к рациональной терапии пациентов. Consilium Medicum. 2018; 20 (2): 128–135. DOI: 10.26442/2075-1753_2018.2.128-135
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Аннотация
Мигрень отличается высокой дезадаптацией и существенным снижением качества жизни пациентов в связи с частотой, длительностью и тяжестью приступов головной боли. Несмотря на широкую распространенность заболевания, путь от постановки диагноза, до подбора эффективной терапии и значимого улучшения качества жизни больных с мигренью порой занимает много лет. Этот вариант первичной головной боли отличается выраженным полиморфизмом приступов, и совсем непросто выбрать оптимальное средство для купирования боли. Наиболее эффективные селективные агонисты 5НТ1В/1D-рецепторов серотонина (триптаны) недостаточно часто применяются даже у больных с тяжелыми и длительными приступами; не все пациенты осведомлены об их существовании или не удовлетворены их эффектом, что нередко связано с неправильным применением препаратов во время мигренозного приступа. В этой связи предметом активного исследования продолжает оставаться изучение средств из группы триптанов, являющихся наиболее эффективными, патогенетически обоснованными препаратами для терапии мигренозных атак. Анализ клинического применения отечественного препарата Мигрепам® (золмитриптан) для купирования приступов мигрени без ауры продемонстрировал его высокую эффективность, хорошую переносимость и безопасность, а также значительную приверженность пациентов терапии препаратом Мигрепам® в дальнейшем.
Ключевые слова: мигрень, триптаны, золмитриптан, Мигрепам.
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Migraine is characterized by high disadaptation and a significant decrease in the quality of life of patients due to the frequency, duration and severity of attacks of headache. Despite the wide prevalence of the disease, the path from diagnosis, selection of effective therapy and significant improvement in the quality of life of patients with migraine sometimes takes many years. This variant of primary headache is distinguished by a significant polymorphism of attacks of cephalalgia, and it is not at all easy to choose the optimal means for relief of pain. The most effective selective agonists of 5HT1B/1D receptors of serotonin (triptans) are not often used even in patients with severe and prolonged attacks, not all patients are aware of their existence or are not satisfied with their effect, which is often associated with improper use of drugs during a migraine attack. In this connection, the study of funds from the group of triptans, which are the most effective, pathogenetically substantiated drugs for the therapy of migraine attacks, continues to be the subject of active research. Analysis of the clinical use of the domestic drug Migrepam® (zolmitriptan) for arresting migraine attacks without an aura demonstrated its high efficacy, good tolerability and safety, and also the high adherence of patients to Migrepam® therapy in the future.
Key word: migraine, triptans, zolmitriptan, Migrepam.
Полный текст
Список литературы
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20. Lucas C, Auray JP, Gaudin AF et al. Use and misuse of triptans in France: Data fron the GRIM 2000 population survey. Cephalalgia 2004; 24: 197–205. DOI: 10.1111/j.1468-2982.2003.00651.x
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27. Loder E, Silberstein SD, Abu-Shakra S et al. Efficacy and tolerability of oral zolmitriptan in menstrually associated migraine: a randomized, prospective, parallelgroup, double-blind, placebo-controlled study. Headache 2004; 44: 120–30. PMID: 14756849
28. The International Classification of Headache Disorders, 3rd edition (beta version). Cephalalgia 2013; 33 (9): 629–808. DOI: 10.1177/0333102413485658
29. Ferrari MD. Should we advise patients to treat migraine attacks early? Cephalalgia 2004; 24: 915–7. DOI: 10.1111/j.1468-2982.2004.00834.x
30. Dodick DW. Triptan nonresponder studies: implications for clinical practice. Headache 2005; 45: 156–62. DOI: 10.1111/j.1526-4610.2005.05031.x
31. Burstein R, Collins B, Jakubowski M. Defeating migraine pain with triptans: a race against the development of cutaneus allodynia. Ann Neurol 2004; 55: 19–26. DOI: 10.1002/ana.10786
32. Schoenen J, Sawyer J. Zolmitriptan (Zomig, 311C90), a novel dual central and peripheral 5HT 1B/1D agonist: an overview of efficacy. Cephalalgia 1997; 17: 28–40. DOI: 10.1177/0333102497017S1805
33. Mauskop A, Farkkila M, Hering-Hanit R et al. Zolmitriptan is effective for the treatment of persistent and recurrent migraine headache. Cur Med Res Opin 1999; 15 (4): 282–9. DOI: 10.1185/03007999909116498
34. Allais G, Tullo V, Benedetto C et al. Efficacy of frovatriptan in the acute treatment of menstrually related migraine: analysis of a double blind, randomized, multicenter, Italian, comparative study versus zolmitriptan. Neurol Sci 2011; 32 (1): S99–104. DOI: 10.1007/s10072-011-0547-y
35. Shapero G, Dowson A, Lacoste J-P, Almqvist P. Improved migraine management in primary care: results of a patient treatment experience study using zolmitriptan orally disintegrating tablet. Int J Clin Pract 2006; 60 (12): 1530–5. DOI: 10.1111/j.1742-1241.2006.01208
________________________________________________
1. Steiner TJ, Birbeck GL, Jensen RH et al. Headache disorders are third cause of disability worldwide. J Headache Pain 2015; 16: 58. DOI: 10.1186/s10194-015-0544-2
2. Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet 2016; 388: 1545–602. DOI: 10.1016/S0140-6736(16)31678-6
3. Tietjen GE, Collins SA. Hypercoagulability and migraine. Headache 2018; 58 (1): 173–83. http://dx.doi.org/10.1111/head.13044
4. Ayzenberg I, Katsarava Z, Sborowski A et al. The prevalence of primary headache disorders in Russia: A countrywide survey. Cephalalgia 2012; 32 (5): 373–81. DOI: 10.1177/0333102412438977
5. Bakar NA, Tanprawate S, Lambru G et al. Quality of life in primary headache disorders: A review. Cephalalgia 2016; 36 (1): 67–91. DOI: 0.1177/0333102415580099
6. Sheikh HU, Pavlovic J, Loder E, Burch R. Risk of stroke associated with use of estrogen containing contraceptives in women with migraine: a systematic review. Headache 2017. DOI: 10.1111/head.13229
7. Buse DC, Reed ML, Fanning KM et al. Cardiovascular events, conditions, and procedures among people with episodic migraine in the US population: results from the American Migraine Prevalence and Prevention (AMPP) study. Headache 2017; 57: 31–44. DOI: 10.1111/head.12962
8. Peng K-P, Chen Y-T, Fuh J-L et al. Migraine and incidence of ischemic stroke: A nationwide population-based study. Cephalalgia 2017; 37 (4): 327–35. http://dx.doi.org/10.1177/0333102416642602
9. Sacco S, Ricci S, Carolei A. Migraine and vascular diseases: a review of the evidence and potential implications for management. Cephalalgia 2012; 32: 785–95. DOI: 10.1177/0333102412451361
10. Wenzel R, Dortch M, Cady R. Migraine headache misconceptions: Barriers to effective car. Pharmacotherapy 2004; 24: 638–48. DOI: 10.1592/phco.24.6.638.34751
11. Lucas C, Chaffaut C, Artaz MA, Lanteri-Minet M. FRAMIG 2000: Medical and therapeutic management of migraine in France. Cephalalgia 2005; 25: 267–79. DOI: 10.1111/j.1468-2982.2004.00851.x
12. Latinovic R, Gulliford M, Ridsdale L. Headache and migraine in primary care: consultation, prescription, and referral rates in a large population. J Neurol Neurosurg Psychiatry 2006; 77: 385–7. DOI: 10.1136/jnnp.2005.073221
13. Minen MT, Loder E, Tishler L, Silbersweig D. Migraine diagnosis and treatment: A knowledge and needs assessment among primary care providers. Cephalalgia 2016; 36 (4): 358–70. http://dx.DOI.org/10.1177/0333102415593086
14. Ekusheva E.V. Optimal'nye podkhody k kupirovaniiu pristupa migreni: proshloe, nastoiashchee i budushchee. RMZh. 2012; 10: 522–8. [in Russian]
15. Ekusheva E.V., Filatova E.G. Golovnaia bol', vyzvannaia seksual'noi aktivnost'iu. Zhurn. nevrologii i psikhiatrii im. Korsakova. 2003; 103 (10): 21–5. [in Russian]
16. Cho S-J, Chu MK. Risk factors of chronic daily headache or chronic migraine. Curr Pain Headache Rep 2015; 19: 465. DOI: 10.1007/s11916-014-0465-9
17. Ekusheva E.V., Osipova V.V., Artemenko A.R. Diagnostika refrakternykh form khronicheskoi pervichnoi golovnoi boli. Zhurn. nevrologii i psikhiatrii im. Korsakova. 2017; 117 (1–2): 48–53. DOI: 10.17116/jnevro20171171248-53 [in Russian]
18. Rizzoli PB. Acute and preventive treatment of migraine. Continuum (Minneap Minn) 2012; 18 (4): 764–82. DOI: 10.1212/01.CON.0000418641.45522.3b
19. Diamond S, Bigal ME, Silberstein S. Patterns of diagnosis and acute and preventive treatment for migraine in the United States: Results from American Migraine Prevalence and Preventive study. Headache 2007; 47: 355–63. DOI: 10.1111/j.1526-4610.2006.00631.x
20. Lucas C, Auray JP, Gaudin AF et al. Use and misuse of triptans in France: Data fron the GRIM 2000 population survey. Cephalalgia 2004; 24: 197–205. DOI: 10.1111/j.1468-2982.2003.00651.x
21. MacGregor EA, Brandes J, Eikermann A. Migraine prevalence and treatment patterns: the global migraine and zolmitriptan evaluation survey MAZE. Headache 2003; 43: 19–26. PMID: 12864754
22. Ifergane G, Wirguin I, Shvartzman P. Triptans – Why once? Headache 2006; 46: 1261–3. http://dx.DOI.org/10.1111/j.1526-4610.2006.00435.x
23. Ferrari MD, Roon KI, Lipton RB, Goadsby PJ. Oral triptans (serotonin 5HT1B/1D agonists) in acute migraine treatment: a meta–analysis of 53 trials. Lancet 2001; 358: 1668–75. DOI: 10.1016/S0140-6736(01)06711-3
24. Gallagner RM, Dennish G, Spierings ELH, Chitra R. A comparative trial of zolmitriptan and sumatriptan for the acute oral treatment of migraine. Headaсhe 2000; 40: 119–28. PMID: 10759911
25. Bird S, Derry S, Moore RA. Zolmitriptan for acute migraine attacks in adults. Cochrane Database Syst Rev. 2014; 5: CD008616. DOI: 10.1002/14651858.CD008616.pub2
26. Spierings EL, Brandes JL, Kudrow DB et al. Randomized, double-blind, placebo controlled, parallel-group, multi-center study of the safety and efficacy of ADAM zolmitriptan for the acute treatment of migraine. Cephalalgia 2018; 38 (2): 215–24. DOI: 10.1177/0333102417737765
27. Loder E, Silberstein SD, Abu-Shakra S et al. Efficacy and tolerability of oral zolmitriptan in menstrually associated migraine: a randomized, prospective, parallelgroup, double-blind, placebo-controlled study. Headache 2004; 44: 120–30. PMID: 14756849
28. The International Classification of Headache Disorders, 3rd edition (beta version). Cephalalgia 2013; 33 (9): 629–808. DOI: 10.1177/0333102413485658
29. Ferrari MD. Should we advise patients to treat migraine attacks early? Cephalalgia 2004; 24: 915–7. DOI: 10.1111/j.1468-2982.2004.00834.x
30. Dodick DW. Triptan nonresponder studies: implications for clinical practice. Headache 2005; 45: 156–62. DOI: 10.1111/j.1526-4610.2005.05031.x
31. Burstein R, Collins B, Jakubowski M. Defeating migraine pain with triptans: a race against the development of cutaneus allodynia. Ann Neurol 2004; 55: 19–26. DOI: 10.1002/ana.10786
32. Schoenen J, Sawyer J. Zolmitriptan (Zomig, 311C90), a novel dual central and peripheral 5HT 1B/1D agonist: an overview of efficacy. Cephalalgia 1997; 17: 28–40. DOI: 10.1177/0333102497017S1805
33. Mauskop A, Farkkila M, Hering-Hanit R et al. Zolmitriptan is effective for the treatment of persistent and recurrent migraine headache. Cur Med Res Opin 1999; 15 (4): 282–9. DOI: 10.1185/03007999909116498
34. Allais G, Tullo V, Benedetto C et al. Efficacy of frovatriptan in the acute treatment of menstrually related migraine: analysis of a double blind, randomized, multicenter, Italian, comparative study versus zolmitriptan. Neurol Sci 2011; 32 (1): S99–104. DOI: 10.1007/s10072-011-0547-y
35. Shapero G, Dowson A, Lacoste J-P, Almqvist P. Improved migraine management in primary care: results of a patient treatment experience study using zolmitriptan orally disintegrating tablet. Int J Clin Pract 2006; 60 (12): 1530–5. DOI: 10.1111/j.1742-1241.2006.01208
Авторы
Е.В.Екушева*1, Е.Г.Филатова2
1 ФГБОУ ДПО «Институт повышения квалификации» ФМБА России. 125371, Россия, Москва, Волоколамское ш., д. 91;
2 ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М.Сеченова» Минздрава России. 119991, Россия, Москва, ул. Трубецкая, д. 8, стр. 2
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E.V.Ekusheva*1, E.G.Filatova2
1 Institute of Professional Development of FMBA of Russia. 125371, Russian Federation, Moscow, Volokolamskoe sh., d. 91;
2 I.M.Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation. 119991, Russian Federation, Moscow, ul. Trubetskaia, d. 8, str. 2
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