New drugs in migraine treatment and prophylaxis: telcagepant and topiramate
New drugs in migraine treatment and prophylaxis: telcagepant and topiramate
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DOI：
10.1016/s0140-6736(10)60323-6
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发表时间：
2010-08-21
期刊：
影响因子：
168.9
通讯作者：
Linde, Mattias
中科院分区：
文献类型：
--
作者：
Edvinsson, Lars;Linde, Mattias
尽管曲普坦药物为许多患者提供了有效的偏头痛缓解，但相当数量的受影响个人对这些化合物没有反应，而且这种治疗也可能导致一系列不良反应。Telcagepant代表了一种新型的抗偏头痛药物--降钙素基因相关多肽受体阻滞剂。这种化合物通过在三叉神经和中枢神经系统的几个部位阻断降钙素基因相关肽的受体来发挥其作用，从而缓解疼痛。电感受剂不会引起血管收缩，这是曲普坦使用的一个主要限制。在偏头痛急性发作的临床试验中与曲普坦进行比较，发现临床效果与曲普坦相似，但优于安慰剂。心灵感受器可能会为那些对旧药反应不佳或无法使用的人带来希望。对于由于偏头痛频繁发作而需要预防的患者，托吡酯是许多国家预防偏头痛的一线药物；它通常是安全的，耐受性相当好。数据显示，托吡酯可以帮助慢性偏头痛逆转为发作性偏头痛。
Although the triptan drugs provide effective relief from migraine for many patients, a substantial number of affected individuals are unresponsive to these compounds, and such therapy can also lead to a range of adverse effects. Telcagepant represents a new class of antimigraine drug-the calcitonin gene-related peptide receptor blockers. This compound exerts its effects by blocking receptors for the calcitonin-gene-related peptide at several sites in the trigeminal and central nervous systems, resulting in pain relief. Telcagepant does not cause vasoconstriction, a major limitation in the use of triptans. Comparisons with triptans in clinical trials for acute treatment of migraine attacks revealed clinical effects similar to those of triptans but better than those of placebo. Telcagepant might provide hope for those who have a poor response to, or are unable to use, older drugs. In patients who need prophylaxis because of frequent attacks of migraine, topiramate is a first-line drug for migraine prevention in many countries; it is generally safe and reasonably well tolerated. Data suggest that topiramate could aid reversion of chronic migraine to episodic migraine.