InterMiG: international differences in the therapeutic approach to migraine patients in specialized headache centers.

Autor: Gago-Veiga AB; Headache Unit, Department of Neurology, La Princesa Research Institute. Hospital Universitario de la Princesa, Madrid, Spain. dra.anagago@gmail.com., Huhn JI; Praxis Gendolla. Zentrum für Neurologie und Schmerztherapie, Essen, Germany., Latysheva N; Department of Neurology, Institute for Professional Education, I.M.Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia., Vieira Campos A; Headache Unit, Department of Neurology, La Princesa Research Institute. Hospital Universitario de la Princesa, Madrid, Spain., Torres-Ferrus M; Headache Unit, Neurology Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain.; Headache and Neurological Pain Research Group, Vall d'Hebron Research Institute, Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain., Alpuente Ruiz A; Headache Unit, Neurology Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain.; Headache and Neurological Pain Research Group, Vall d'Hebron Research Institute, Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain., Sacco S; Neuroscience Section, Department of Applied Clinical Sciences and Biotechnology, University of L'Aquila, L´Aquila, Italy., Frattale I; Neuroscience Section, Department of Applied Clinical Sciences and Biotechnology, University of L'Aquila, L´Aquila, Italy., Ornello R; Neuroscience Section, Department of Applied Clinical Sciences and Biotechnology, University of L'Aquila, L´Aquila, Italy., Ruscheweyh R; Department of Neurology, Ludwig Maximilians University Munich, Munich, Germany., Marques IB; Department of Neurology, Hospital da Luz Lisboa, Lisbon, Portugal., Gryglas-Dworak A; Private Headache Clinic, Wroclaw, Poland., Stark C; Austin Health, Heidelberg, Australia., Gallardo VJ; Headache Unit, Neurology Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain.; Headache and Neurological Pain Research Group, Vall d'Hebron Research Institute, Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain., Pozo-Rosich P; Headache Unit, Neurology Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain.; Headache and Neurological Pain Research Group, Vall d'Hebron Research Institute, Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain.
Jazyk: angličtina
Zdroj: The journal of headache and pain [J Headache Pain] 2021 May 24; Vol. 22 (1), pp. 43. Date of Electronic Publication: 2021 May 24.
DOI: 10.1186/s10194-021-01258-y
Abstrakt: Background: There is currently a wide therapeutic arsenal for migraine patients, without a single first-line preventive drug and we choose the different available alternatives taking into account comorbidities, national guidelines, previous treatments and personal experiences. Our objective was to evaluate the differences in the use of migraine treatments between neurologists from different countries.
Methods: This is a multi-centre observational study carried out by neurologists from specialized headache units in seven countries, retrospective with consecutive inclusion of all patients presenting with a migraine diagnosis, over a period of three months.
Results: A total of 734 patients were recruited but only 600 were considered in the analysis in order to homogenize the patient cohorts from countries: 200 Spain (ES), 100 Italy (IT), 85 Russia (RUS), 80 Germany (DE), 60 Portugal (PT), 45 Poland (PL) and 30 Australia (AU). 85.4 % of patients were women with a mean age of 42.6 ± 11.8 years. Considering previous and current preventive treatment, the order of use was: antidepressants (69.3 %), antiepileptic drugs (54.7 %), beta-blockers and antihypertensive drugs (49.7 %), OnabotulinumtoxinA (44.0 %) and others (36.2 %). Statistically significant differences were found between all pharmacological classes: antidepressants were commonly used in all countries, with the exception of Poland (AU: 76.7 %, IT: 71.0 %, DE: 60.0 %, PL: 31.1 %, PT: 71.7 %, RUS: 70.6 %, ES: 78.5 %; p < 0.0001); antiepileptic drugs were more frequently prescribed in Portugal, Australia and Spain (AU: 73.3 %, IT: 40.0 %, DE: 37.5 %, PL: 48.9 %, PT: 85.0 %, RUS: 29.4 % and ES: 69.0 %; p < 0.0001); beta-blockers and antihypertensive drugs were frequently used in all countries except Italy (AU: 60.0 %, IT: 14.0 %, DE: 53.8 %, PL: 48.9 %, PT: 68.3 %, RUS: 49.4 % and ES: 59.0 %; p < 0.0001); BTX-A were predominately used in Spain, Italy and Australia (AU:56.7 %, IT:58.0 %, DE:20.0 %, PL: 42.2 %, PT: 26.7 %, RUS: 24.7 % and ES: 58.5 %; p < 0.0001) and others were most frequently used in Poland (AU: 0.0 %, IT: 19.0 %, DE: 42.5 %, PL: 95.6 %, PT: 31.7 %, RUS: 3.5 % and ES: 49.5 %; p < 0.0001). If only patients without comorbidities are considered (200/600), statistically differences between countries persist in all preventive treatments.
Conclusions: There is heterogeneity in the choice of preventive treatment between different countries. Prospective comparative studies of the different oral and subcutaneous alternatives would help to create a global therapeutic algorithm that would guarantee the best option for our patients.
Databáze: MEDLINE
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