偏头痛治疗:法国头痛协会立场文件。

IF 2.8 4区 医学 Q2 CLINICAL NEUROLOGY Revue neurologique Pub Date : 2024-10-14 DOI:10.1016/j.neurol.2024.09.008
X Moisset, G Demarquay, S de Gaalon, C Roos, A Donnet, P Giraud, E Guégan-Massardier, C Lucas, J Mawet, D Valade, V Corand, C Gollion, N Moreau, L Grangeon, M Lantéri-Minet, A Ducros
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引用次数: 0

摘要

法国偏头痛管理建议于 2021 年发布。然而,在过去三年中,新的数据不断涌现,欧洲药品管理局也批准了新的药物(eptinezumab、rimgepant和atogepant),这就要求我们对这些药物的使用采取立场,并更新建议中的某些内容。第一个重要信息涉及法国头痛协会对使用针对降钙素基因相关肽(CGRP)通路的预防性治疗(单克隆抗体和gepants)的立场。就疗效和安全性而言,正如其他国家的头痛学会所建议的那样,这些疗法可作为一线治疗手段,但法国国家卫生当局规定的可报销范围仅限于严重偏头痛患者、每月头痛天数至少8天且之前两种预防性疗法均无效的患者。另一个重要变化涉及托吡酯作为育龄妇女偏头痛预防治疗药物的地位。该疗法已被建议作为慢性偏头痛的一线治疗方法。然而,最近的药物警戒数据显示,该药物可能会对子宫内接触该药物的儿童的神经发育产生不良影响。因此,该疗法被正式列为妊娠期禁忌症,育龄妇女在使用该疗法时必须格外谨慎(采取有效的避孕措施,没有其他治疗方法可供选择,并与丙戊酸钠一样每年进行随访)。因此,不能再将其作为育龄妇女的一线治疗药物。
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Migraine treatment: Position paper of the French Headache Society.

The French migraine management recommendations were published in 2021. However, in the last three years, new data have come to light and new drugs have been approved (eptinezumab, rimegepant and atogepant) by the European Medicines Agency that require us to take a position on their use and to update certain elements of the recommendations. The first important message concerns the position of the French Headache Society on the use of preventive treatments (monoclonal antibodies and gepants) targeting the calcitonin gene-related peptide (CGRP) pathway. In terms of efficacy and safety, and as suggested by other national headache societies, these treatments can be offered as first-line treatment, although the scope defined by the French national health authority for possible reimbursement is limited to patients with severe migraine, at least eight headache days per month and for whom two previous preventive treatments have failed. Another important change concerns the position of topiramate as a preventive treatment for migraine in women of childbearing age. This treatment has been proposed as a first-line treatment for chronic migraine. However, recent pharmacovigilance data have highlighted a potential adverse effect on neurodevelopment in children exposed in utero. As a result, this treatment is formally contraindicated during pregnancy and must be used with extreme caution in women of childbearing age (effective contraception, no therapeutic alternative available and annual follow-up as with valproate). It can therefore no longer be offered as first-line treatment for women of childbearing age.

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来源期刊
Revue neurologique
Revue neurologique 医学-临床神经学
CiteScore
4.80
自引率
0.00%
发文量
598
审稿时长
55 days
期刊介绍: The first issue of the Revue Neurologique, featuring an original article by Jean-Martin Charcot, was published on February 28th, 1893. Six years later, the French Society of Neurology (SFN) adopted this journal as its official publication in the year of its foundation, 1899. The Revue Neurologique was published throughout the 20th century without interruption and is indexed in all international databases (including Current Contents, Pubmed, Scopus). Ten annual issues provide original peer-reviewed clinical and research articles, and review articles giving up-to-date insights in all areas of neurology. The Revue Neurologique also publishes guidelines and recommendations. The Revue Neurologique publishes original articles, brief reports, general reviews, editorials, and letters to the editor as well as correspondence concerning articles previously published in the journal in the correspondence column.
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