Elevated Saliva Calcitonin Gene-Related Peptide Levels During Acute Migraine Predict Therapeutic Response to Rizatriptan
Elevated Saliva Calcitonin Gene-Related Peptide Levels During Acute Migraine Predict Therapeutic Response to Rizatriptan
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DOI：
10.1111/j.1526-4610.2009.01523.x
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发表时间：
2009-10-01
期刊：
影响因子：
5
通讯作者：
Durham, Paul L.
中科院分区：
文献类型：
--
作者：
Cady, Roger K.;Vause, Carrie V.;Durham, Paul L.
目标。(1)测量偏头痛患者在先兆期、轻度头痛、中度至重度头痛和缓解后阶段的唾液中降钙素基因相关肽（CGRP）水平，并与基线（发作间期）CGRP水平进行比较。(2)为了将中度头痛期间对利扎曲普坦的反应与唾液中测量的CGRP水平相关联。CGRP与偏头痛的潜在病理生理学有关。迄今为止，没有研究通过偏头痛发作的临床演变测量唾液CGRP的变化，并将唾液CGRP水平与对治疗的临床反应相关联。使用表格和描述性统计量总结数据。使用Minitab 15统计软件，采用非参数符号秩检验进行统计分析。统计分析结果在P <0.05时被认为是显著的。应答受试者定义为末次采集唾液样本时无症状且无需急救的受试者。无反应的受试者被定义为那些谁拯救了额外剂量的利扎曲普坦或其他药物或谁不是症状免费在收集期结束。与基线（发作间期）水平相比，在偏头痛的先兆期、轻度头痛期和中度至重度头痛期观察到CGRP统计学显著升高。在唾液CGRP水平升高的受试者中观察到对利扎曲普坦的更好的治疗反应。利扎曲普坦的成功治疗与唾液CGRP水平恢复到接近基线水平相关。在利扎曲普坦无反应组中，在偏头痛发作的任何阶段均未发现唾液CGRP水平的显著变化。唾液CGRP升高可预测利扎曲普坦的反应性。在利扎曲普坦应答人群中，CGRP水平从先兆期开始升高，并贯穿轻度和中度/重度头痛。对利扎曲普坦的成功应答与唾液CGRP水平恢复至接近基线（发作间期）值相关。
Objectives.-(1) To measure calcitonin gene-related peptide (CGRP) levels in the saliva of individuals with migraine during the premonitory period, mild headache, moderate to severe headache, and post-resolution phases as compared with baseline (interictal) CGRP levels. (2) To correlate response to rizatriptan administered during moderate headache with levels of CGRP levels measured in saliva.Background.-CGRP is implicated in the underlying pathophysiology of migraine. To date no study has measured changes of saliva CGRP through the clinical evolution of a migraine attack and correlated saliva CGRP levels to clinical response to therapy.Methods.-Data were summarized using tables and descriptive statistics. Statistical analysis was performed with the non-parametric signed-rank test using Minitab15 statistical software. Results of statistical analyses were considered significant at P < .05. Responding subjects were defined as those who were symptom free at the time of the last collected saliva sample and did not have to rescue. Non-responding subjects were defined as those who rescued with an additional dose of rizatriptan or another medication or who were not symptom free at the end of the collection period.Results.-Statistically significant elevations of CGRP were noted in the premonitory, mild headache, and moderate to severe headache phase of the migraine compared with baseline (interictal) levels. A better therapeutic response to rizatriptan was observed in subjects with elevated saliva CGRP levels. Successful treatment with rizatriptan correlated with saliva CGRP levels returning to near baseline levels. In the rizatriptan non-responder group, no significant change in saliva CGRP levels was found at any phase of the migraine attack.Conclusions.-Elevation of saliva CGRP is predictive of responsiveness to rizatriptan. In the rizatriptan responsive population, CGRP levels are elevated beginning with the premonitory period and throughout mild and moderate/severe headache. Successful response to rizatriptan correlated with return of saliva CGRP levels to near baseline (interictal) values.