Effect of comorbid migraine on propranolol efficacy for painful TMD in a randomized controlled trial.
Effect of comorbid migraine on propranolol efficacy for painful TMD in a randomized controlled trial.
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DOI：
10.1177/0333102421989268
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发表时间：
2021-06
期刊：
影响因子：
--
通讯作者：
Slade GD
中科院分区：
文献类型：
--
作者：
Tchivileva IE;Ohrbach R;Fillingim RB;Lim PF;Giosia MD;Ribeiro-Dasilva M;Campbell JH;Hadgraft H;Willis J;Arbes SJ Jr;Slade GD
偏头痛预防药物普萘洛尔在减轻颞下颌关节紊乱引起的疼痛方面是有效的，这表明它可能对共病偏头痛有调节或调节作用。在这项随机对照试验中，肌筋膜颞下颌关节紊乱病患者接受普萘洛尔或安慰剂治疗9周。主要终点是从每日症状日记中得出的面部疼痛指数的变化。线性和逻辑回归模型测试偏头痛×治疗组在降低面部疼痛指数方面的相互作用。反事实模型探讨了头痛影响和心率的变化作为普萘洛尔疗效的介质。普萘洛尔在104名偏头痛患者中降低面部疼痛指数的疗效大于95名非偏头痛患者：例如，面部疼痛指数降低≥ 30%的二元比值比为3.3（95%置信限：1.4，8.1）与1.3（0.5，3.2），尽管相互作用在统计学上不显著（p = 0.139）。累积反应曲线证实偏头痛患者的疗效高于非偏头痛患者（曲线下面积差异分别为26%和6%; p = 0.081）。虽然9%的治疗效果是通过减少头痛影响来介导的，但46%是通过降低心率来介导的。普萘洛尔在减轻偏头痛患者的颞下颌关节紊乱疼痛方面比非偏头痛患者更有效，其作用更多是通过降低心率而不是减少头痛影响来介导的。SOPPRANO; NCT 02437383; https://clinicaltrials.gov/ct2/show/NCT02437383
The migraine-preventive drug propranolol is efficacious in reducing pain from temporomandibular disorder, suggesting potential modifying or mediating effects of comorbid migraine. In this randomized controlled trial, myofascial temporomandibular disorder patients were treated with propranolol or placebo for 9 weeks. The primary endpoint was change in a facial pain index derived from daily symptom diaries. Linear and logistic regression models tested for a migraine × treatment-group interaction in reducing facial pain index. Counterfactual models explored changes in headache impact and heart rate as mediators of propranolol's efficacy. Propranolol's efficacy in reducing facial pain index was greater among the 104 migraineurs than the 95 non-migraineurs: For example, for the binary ≥ 30% reduction in facial pain index, odds ratios were 3.3 (95% confidence limits: 1.4, 8.1) versus 1.3 (0.5, 3.2), respectively, although the interaction was statistically non-significant (p = 0.139). Cumulative response curves confirmed greater efficacy for migraineurs than non-migraineurs (differences in area under the curve 26% and 6%, respectively; p = 0.081). While 9% of the treatment effect was mediated by reduced headache impact, 46% was mediated by reduced heart rate. Propranolol was more efficacious in reducing temporomandibular disorder pain among migraineurs than non-migraineurs, with more of the effect mediated by reduced heart rate than by reduced headache impact. SOPPRANO; NCT02437383; https://clinicaltrials.gov/ct2/show/NCT02437383
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影响因子：
2.5
作者：
Schiffman E;Ohrbach R;Truelove E;Look J;Anderson G;Goulet JP;List T;Svensson P;Gonzalez Y;Lobbezoo F;Michelotti A;Brooks SL;Ceusters W;Drangsholt M;Ettlin D;Gaul C;Goldberg LJ;Haythornthwaite JA;Hollender L;Jensen R;John MT;De Laat A;de Leeuw R;Maixner W;van der Meulen M;Murray GM;Nixdorf DR;Palla S;Petersson A;Pionchon P;Smith B;Visscher CM;Zakrzewska J;Dworkin SF;International RDC/TMD Consortium Network, International association for Dental Research;Orofacial Pain Special Interest Group, International Association for the Study of Pain
通讯作者：
Orofacial Pain Special Interest Group, International Association for the Study of Pain
影响因子：
4.9
作者：
Smelt, Antonia F. H.;Assendelft, Willem J. J.;Blom, Jeanet W.
通讯作者：
Blom, Jeanet W.
影响因子：
105.7
作者：
Sun, Xin;Briel, Matthias;Guyatt, Gordon H.
通讯作者：
Guyatt, Gordon H.
DOI：
10.1016/j.coms.2016.03.004
发表时间：
2016-08-01
影响因子：
1.5
作者：
Graff-Radford, Steven B.;Abbott, Jeremy J.
通讯作者：
Abbott, Jeremy J.
DOI：
10.14219/jada.archive.2006.0385
发表时间：
2006-09-01
影响因子：
3.9
作者：
Mitrirattanakul, Somsak;Merrill, Robert L.
通讯作者：
Merrill, Robert L.