中风与神经疾病杂志2025，Vol.42Issue(7)：610-614,5.DOI:10.19845/j.cnki.zfysjjbzz.2025.0116
美国医师协会发作性偏头痛门诊药物预防临床指南解读
Interpretation of prevention of episodic migraine headache using pharmacologic treatments in outpatient settings:A clinical guideline from the American College of Physicians
摘要
Abstract
The American College of Physicians(ACP)has developed a clinical practice guideline for the manage-ment of episodic migraine(defined as headache occurring on 1 to 14 days per month)in adults in outpatient settings.Based on a systematic literature review,this guideline reviews the benefits and harms of pharmacologic treatments,patient values and preferences,and health economic evidence,the Grading of Recommendations Assessment,Development and Evaluation approach was used to perform evidence-based evaluation of interventions.The guideline systematically evalu-ates the efficacy and safety of the following drug classes of angiotensin-converting enzyme inhibitor(lisinopril),angioten-sin Ⅱ receptor antagonists(candesartan/telmisartan),antiseizure medications(sodium valproate/topiramate),β-blockers(metoprolol/propranolol),calcitonin gene-related peptide pathway modulators(including the gepants such as atogepant/rimegepant and the monoclonal antibodies such as eptinezumab/erenumab/fremanezumab/galcanezumab),serotonergic agents(fluoxetine/venlafaxine),and tricyclic antidepressant(amitriptyline).The key outcomes evaluated include mi-graine frequency,migraine duration,number of acute medication intake days,frequency of migraine-related emergency department visits,migraine-related disability,quality of life,and discontinuations due to adverse events,and FDA labels and research data from eligible studies were used to assess drug safety.The guideline puts forward three core recommenda-tions with conditional strength(based on low-certainty evidence):clinicians should initiate monotherapy to prevent epi-sodic migraine in nonpregnant adults in outpatient settings;clinicians should consider alternative treatments in patients who do not tolerate or have inadequate response to initial therapy.In addition,the guideline provides clinical consider-ations to support evidence-based decision-making among internists and other clinicians.关键词
偏头痛/门诊/预防性用药Key words
Migraine/Outpatient settings/Preventive pharmacotherapy分类
医药卫生引用本文复制引用
李一凡,董铭,董天一,陈俊玮,仲芳田,莫多,张吴琼,吴百华,施苗,于澎..美国医师协会发作性偏头痛门诊药物预防临床指南解读[J].中风与神经疾病杂志,2025,42(7):610-614,5.基金项目
吉林省卫生健康科技能力提升项目(2024A015) （2024A015）
吉林省自然科学基金面上项目(医学科学领域)(YDZJ202501ZYTS084) （医学科学领域）
国家重点研发项目子课题(2023YFC2508701) （2023YFC2508701）
