Negative predictors of clinical response to triptans in patients with migraine
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : M. Ishii • Y. Sakairi • H. Hara • A. Imagawa • S. Shimizu • J. Takahashi • A. Nagamine • Y. Naito • Y. Masuda • S. Usami • Y. Kiuchi
- چاپ و سال / کشور: 2011
Description
Moderate to severe migraine attacks are treated with triptans. However, about 25% of migraineurs fail to respond to triptans. We investigated the involvement of gene polymorphisms, personality traits and characteristics of headache, and made a scoring system for prediction of clinical response to triptans in patients with migraine. Gene polymorphisms including serotonin (5-HT)1B receptor G861C and dopamine receptor 2 (DRD2) C939T, personality traits and characteristics of headache were investigated in 46 consistent responders and 14 inconsistent responders to triptans. The multivariate stepwise logistic regression analysis revealed that age, periorbital/deep orbital pain and C/C genotype carrier at DRD2 C939T were significant factors that contributed independently to the negative response to triptans in patients with migraine. Their odds ratios were 6.329 (40–69 vs. 20–39 years, 95% CI 1.441–27.778), 6.772 (no vs. yes, periorbital/deep orbital pain, 95% CI 1.159–39.580) and 14.085 (non-C/C vs. C/C genotype at DRD2 C939T, 95% CI 1.253–166.667), respectively. The predictive index (PI) of clinical response to triptans in patients with migraine was calculated using these three factors. The score in inconsistent responders (1.6 ± 0.6) was significantly higher than that in consistent responders (0.8 ± 0.7, P\0.001). Sensibility of low-score (RI = 0) group was 100%, and specificity of high-score (PI C 2) group was 87%. The proposed scoring system should in the future be the object of larger studies to confirm its validity.
Neurol Sci DOI 10.1007/s10072-011-0716-z Received: 23 March 2011 / Accepted: 14 July 2011
