How Does Migraine Change After 10 Years? A Clinical Cohort Follow-Up Analysis
How Does Migraine Change After 10 Years? A Clinical Cohort Follow-Up Analysis
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DOI：
10.1111/head.13774
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发表时间：
2020-02-18
期刊：
影响因子：
5
通讯作者：
Pozo-Rosich, Patricia
中科院分区：
文献类型：
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作者：
Caronna, Edoardo;Jose Gallardo, Victor;Pozo-Rosich, Patricia
目的描述一组偏头痛患者10年的演变过程，重点分析影响其预后的因素。背景偏头痛是最常见的致残性疾病之一，偏头痛患者经常想了解其病情演变的时间轴。然而，长期随访的纵向研究的数据是稀缺的。方法这是一个10年的纵向研究。2008年，我们招募了1109名连续的偏头痛患者，他们回答了初步调查。2018年，我们做了一个跟进。我们比较了初始和最终（10年后）数据。头痛天数/月减少≥ 50%视为改善。结果10年后，380例患者完成了调查（34.3%的初始队列），77.1%（293/380）是女性，平均年龄41.0 +/- 10.6岁，73.7%（280/380）的初步诊断为发作性偏头痛（EM）。10年后，48.2%（183/380）的患者没有对他们的偏头痛进行医学随访; 47.4%（180/380）的频率下降>= 50%，与初始结果相比，EM的比例增加（73.7% vs 87.4%）（P <0.001）。与改善独立相关的因素包括：基线频率>10天/月（OR[95%]：3.04 [1.89，4.89]; P < .001）、不吸烟（2.13 [1.23，3.67]; P = .006）和偏头痛的医疗随访（2.45 [1.54，3.90]; P < .001）。此外，10年后，我们观察到预防性治疗的使用减少（48.7%比23.5%），单药治疗增加（42.2%比72.7%）（P <0.001）。除了偏头痛的自然病理生理学，有一个医疗随访和健康的习惯，如不吸烟是与改善相关的独立因素。
Objective To describe the 10-year evolution of a cohort of migraine patients, focusing on prognostic factors of improvement.Background Migraine is one of the most prevalent and disabling diseases and migraineurs often want to know about the evolutionary timeline of their condition. Yet, data from longitudinal studies with a long-term follow-up is scarce.Methods This is a 10-year longitudinal study. In 2008, we recruited 1109 consecutive migraine patients who answered an initial survey. In 2018, we did a follow-up. We compared initial and final (after 10 years) data. A reduction >= 50% in Headache days/month was considered as improvement. A comparative study was carried out to identify predictors of improvement or no improvement.Results After 10 years, 380 patients completed the survey (34.3% of the initial cohort), 77.1% (293/380) were women; mean age 41.0 +/- 10.6 years and 73.7% (280/380) had an initial diagnosis of episodic migraine (EM). After 10 years, 48.2% (183/380) of patients did not have a medical follow-up of their migraine; 47.4% (180/380) decreased >= 50% in frequency, which increased the proportion of EM (73.7% vs 87.4%) (P < .001) as compared to the initial results. Factors independently associated with improvement were: a baseline frequency >10 days/month (OR[95%]: 3.04 [1.89, 4.89]; P < .001), nonsmoking (2.13 [1.23, 3.67]; P = .006) and a medical follow-up for migraine (2.45 [1.54, 3.90]; P < .001). Additionally, after 10 years, we observed a reduction in the use of preventive treatment (48.7% vs 23.5%) and an increase in monotherapy (42.2% vs 72.7%) (P < .001).Conclusion After 10 years, in almost half of the patients who answered the survey, migraine improved. Other than the natural pathophysiology of migraine, having a medical follow-up and healthy habits such as nonsmoking were independent factors associated with improvement.