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Wang Y, Lou Y, Chen Y, Shi J, Zhang H. Construction and validation of a nomogram for predicting remission of migraine patients with patent foramen ovale after closure. Int J Cardiol 2024; 407:132026. [PMID: 38609055 DOI: 10.1016/j.ijcard.2024.132026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Revised: 02/29/2024] [Accepted: 04/04/2024] [Indexed: 04/14/2024]
Abstract
OBJECTIVE This study aimed to construct and validate a nomogram model that predicts the remission of migraine attacks by screening factors that affect the prognosis of migraine patients with patent foramen ovale (PFO) after closure. METHOD Retrospective analysis was conducted in migraine patients with PFO who underwent PFO closure in the Department of Cardiology of Jiangsu Province Hospital from September 2020 to April 2023. Based on the Migraine Disability Assessment (MIDAS) scores from the 1-year follow-up after PFO closure, all patients who met the inclusion criteria were categorized into a remission group and a non-remission group. The primary efficacy endpoint was remission of migraine headache. After collecting clinical data, transcranial doppler sonography (TCD) results and MIDAS scores, LASSO (least absolute shrinkage and selection operator) regression and multivariable logistic regression analysis were used to filter variables predictive to migraine remission and construct the nomogram model. The Nomogram's accuracy and consistency were respectively assessed through Receiver Operating Characteristic (ROC) curves and calibration curves. Additionally, an analysis of decision curves (DCA) was conducted to evaluate the clinical utility of this newly developed model. RESULT A total of 241 consecutive patients were included in the study. The remission group included 21 males and 93 females, with a median age of 39 (30.25,50) years. The non-remission group included 26 males and 101 females, with a median age of 35 (25.5,47.5) years. All Patients were randomly divided into a training cohort and a validation cohort. Multivariable logistic regression analysis showed that 5 independent predictors, including MIDAS before closure (p = 0.0002), mitigating factors (p = 0.0057), number of attacks/month (p = 0.0058), TCD (p = 0.0093) and Platelet Crit (PCT) (p = 0.0351), played a significant role in the prediction of remission of migraine patients with PFO after closure. Based on these independent predictors, the predictive nomogram model of migraine remission in PFO patients was constructed. The application of the nomogram in the training cohort exhibited good discrimination (area under the ROC curve was 0.7763[95% CI 0.7108-0.8418]), which was confirmed in the validation cohort (AUC was 0.704[95% CI 0.5533-0.8547]). The calibration curve showed that the nomogram model demonstrated good calibration performance. Additionally, the decision curve analysis indicated the clinical utility of the nomogram model. CONCLUSION The construction of the nomogram model had a considerable predictive accuracy for migraine remission in patients after PFO closure, which may provide constructive guidance for clinical decision making.
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Affiliation(s)
- Yifei Wang
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
| | - Yuxuan Lou
- Southeast University School of Medicine, Nanjing, China.
| | - Yanlin Chen
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
| | - Jing Shi
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
| | - Hao Zhang
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
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Cao Z, Han K, Lu H, Illangamudalige S, Shaheed CA, Chen L, McLachlan AJ, Patanwala AE, Maher CG, Lin CWC, March L, Ferreira ML, Mathieson S. Paracetamol Combination Therapy for Back Pain and Osteoarthritis: A Systematic Review and Meta-Analyses. Drugs 2024:10.1007/s40265-024-02065-w. [PMID: 38937394 DOI: 10.1007/s40265-024-02065-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/06/2024] [Indexed: 06/29/2024]
Abstract
BACKGROUND AND OBJECTIVE Although paracetamol (acetaminophen) combined with other analgesics can reduce pain intensity in some pain conditions, its effectiveness in managing low back pain and osteoarthritis is unclear. This systematic review investigated whether paracetamol combination therapy is more effective and safer than monotherapy or placebo in low back pain and osteoarthritis. METHODS Online database searches were conducted for randomised trials that evaluated paracetamol combined with another analgesic compared to a placebo or the non-paracetamol ingredient in the combination (monotherapy) in low back pain and osteoarthritis. The primary outcome was a change in pain. Secondary outcomes were (serious) adverse events, changes in disability and quality of life. Follow-up was immediate (≤ 2 weeks), short (> 2 weeks but ≤ 3 months), intermediate (> 3 months but < 12 months) or long term (≥ 12 months). A random-effects meta-analysis was conducted. Risk of bias was assessed using the original Cochrane tool, and quality of evidence using Grading of Recommendations Assessment, Development and Evaluation (GRADE). RESULTS Twenty-two studies were included. Pain was reduced with oral paracetamol plus a non-steroidal anti-inflammatory drug (NSAID) at immediate term in low back pain (paracetamol plus ibuprofen vs ibuprofen [mean difference (MD) - 6.2, 95% confidence interval (CI) -10.4 to -2.0, moderate evidence]) and in osteoarthritis (paracetamol plus aceclofenac vs aceclofenac [MD - 4.7, 95% CI - 8.3 to - 1.2, moderate certainty evidence] and paracetamol plus etodolac vs etodolac [MD - 15.1, 95% CI - 18.5 to - 11.8; moderate certainty evidence]). Paracetamol plus oral tramadol reduced pain compared with placebo at intermediate term for low back pain (MD - 11.7, 95% CI - 19.2 to - 4.3; very low certainty evidence) and osteoarthritis (MD - 6.8, 95% CI - 12.7 to -0.9; moderate certainty evidence). Disability scores improved in half the comparisons. Quality of life was infrequently measured. All paracetamol plus NSAID combinations did not increase the risk of adverse events compared to NSAID monotherapy. CONCLUSIONS Low-to-moderate quality evidence supports the oral use of some paracetamol plus NSAID combinations for short-term pain relief with no increased risk of harm for low back pain and osteoarthritis compared to its non-paracetamol monotherapy comparator.
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Affiliation(s)
- Zhiying Cao
- Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia
| | - Kaiyue Han
- Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia
| | - Hanting Lu
- Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia
| | | | - Christina Abdel Shaheed
- Institute for Musculoskeletal Health, Sydney Local Health District, Sydney, NSW, Australia
- Faculty of Medicine and Health, Sydney Musculoskeletal Health, The University of Sydney, Sydney, NSW, Australia
| | - Lingxiao Chen
- Department of Orthopedics, Shandong University Centre for Orthopedics, Advanced Medical Research Institute, Qilu Hospital of Shandong University, Shandong University, Jinan, China
- Department of Biostatistics, School of Public Health, Shandong University, Jinan, China
| | - Andrew J McLachlan
- Sydney Pharmacy School, The University of Sydney, Sydney, NSW, Australia
| | - Asad E Patanwala
- Sydney Pharmacy School, The University of Sydney, Sydney, NSW, Australia
- Department of Pharmacy, Royal Prince Alfred Hospital, Sydney Local Health District, Sydney, NSW, Australia
| | - Christopher G Maher
- Institute for Musculoskeletal Health, Sydney Local Health District, Sydney, NSW, Australia
- Faculty of Medicine and Health, Sydney Musculoskeletal Health, The University of Sydney, Sydney, NSW, Australia
| | - Chung-Wei Christine Lin
- Institute for Musculoskeletal Health, Sydney Local Health District, Sydney, NSW, Australia
- Faculty of Medicine and Health, Sydney Musculoskeletal Health, The University of Sydney, Sydney, NSW, Australia
| | - Lyn March
- Northern Clinical School, The University of Sydney, Sydney, NSW, Australia
- Kolling Institute, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Manuela L Ferreira
- Faculty of Medicine and Health, Sydney Musculoskeletal Health, The University of Sydney, Sydney, NSW, Australia
- Kolling Institute, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Stephanie Mathieson
- Faculty of Medicine and Health, Sydney Musculoskeletal Health, The University of Sydney, Sydney, NSW, Australia.
- Kolling Institute, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.
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Alshehri FS, Ashour AM, Alharbi AS, Hakami AY, Alorfi NM. Understanding migraine in Saudi society: An assessment of public knowledge and attitudes: A cross-sectional study. PLoS One 2024; 19:e0304840. [PMID: 38905175 PMCID: PMC11192400 DOI: 10.1371/journal.pone.0304840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Accepted: 05/20/2024] [Indexed: 06/23/2024] Open
Abstract
OBJECTIVE This study aims to assess the knowledge and perceptions of the public toward migraine in Saudi Arabia. METHODS This cross-sectional survey assessed the knowledge and perceptions of migraine among Saudi Arabian individuals. The study was conducted over three months in 2023 (1st of June 2023 to 31st of August 2023) using a prevalidated online questionnaire divided into four sections. RESULTS A total of 1,975 adults aged between 18 and 64 completed the web-based survey. Of these, over half were male (n = 1,268; 64.2%). The main causes of migraine identified by the participants were genetic disease (n = 540, 27.3%), followed by physical disease (n = 341, 17.3%), head trauma (n = 274, 13.9%), and psychiatric disease (n = 157, 7.9%). The main symptoms identified by the participants were photophobia (21%), followed by inability to control urine (14.1%), vomiting and nausea (13.8%), and vision loss (8.3%). The majority of the participants in this study had a good knowledge of migraines, while 49% had poor knowledge. The migraine knowledge score was significantly associated with the participants' gender (p = 0.002), age (p = 0.0001), educational level (p = 0.001), employment status (p = 0.001), monthly income (p = 0.0001), region (p = 0.0001), and history of migraine (p = 0.0001). CONCLUSION Although one-third of the participants exhibiting good knowledge, deficiencies existed in certain clinical aspects, emphasizing the need for targeted educational interventions to enhance public awareness and understanding of migraines.
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Affiliation(s)
- Fahad S. Alshehri
- Pharmacology and Toxicology Department, College of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Ahmed M. Ashour
- Pharmacology and Toxicology Department, College of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Adnan S. Alharbi
- Pharmacy Practice Department, College of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Alqassem Y. Hakami
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
- King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Nasser M. Alorfi
- Pharmacology and Toxicology Department, College of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia
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Tsirelis D, Tsekouras A, Stamati P, Liampas I, Zoupa E, Dastamani M, Tsouris Z, Papadimitriou A, Dardiotis E, Siokas V. The impact of genetic factors on the response to migraine therapy. Rev Neurosci 2024; 0:revneuro-2024-0045. [PMID: 38856190 DOI: 10.1515/revneuro-2024-0045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Accepted: 05/17/2024] [Indexed: 06/11/2024]
Abstract
Migraine is a multidimensional disease affecting a large portion of the human population presenting with a variety of symptoms. In the era of personalized medicine, successful migraine treatment presents a challenge, as several studies have shown the impact of a patient's genetic profile on therapy response. However, with the emergence of contemporary treatment options, there is promise for improved outcomes. A literature search was conducted in PubMed and Scopus, in order to obtain studies investigating the impact of genetic factors on migraine therapy outcome. Overall, 23 studies were included in the current review, exhibiting diversity in the treatments used and the genetic variants investigated. Divergent genes were assessed for each category of migraine treatment. Several genetic factors were identified to contribute to the heterogeneous response to treatment. SNPs related to pharmacodynamic receptors, pharmacogenetics and migraine susceptibility loci were the most investigated variants, revealing some interesting significant results. To date, various associations have been recorded correlating the impact of genetic factors on migraine treatment responses. More extensive research needs to take place with the aim of shedding light on the labyrinthine effects of genetic variations on migraine treatment, and, consequently, these findings can promptly affect migraine treatment and improve migraine patients' life quality in the vision of precise medicine.
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Affiliation(s)
- Daniil Tsirelis
- Department of Neurology, University Hospital of Larissa, Faculty of Medicine, University of Thessaly, 41110 Larissa, Greece
| | - Alexandros Tsekouras
- Department of Neurology, University Hospital of Larissa, Faculty of Medicine, University of Thessaly, 41110 Larissa, Greece
| | - Polyxeni Stamati
- Department of Neurology, University Hospital of Larissa, Faculty of Medicine, University of Thessaly, 41110 Larissa, Greece
| | - Ioannis Liampas
- Department of Neurology, University Hospital of Larissa, Faculty of Medicine, University of Thessaly, 41110 Larissa, Greece
| | - Elli Zoupa
- Larisa Day Care Center of People with Alzheimer's Disease, Association for Regional Development and Mental Health (EPAPSY), 15124 Marousi, Greece
| | - Metaxia Dastamani
- Department of Neurology, University Hospital of Larissa, Faculty of Medicine, University of Thessaly, 41110 Larissa, Greece
| | - Zisis Tsouris
- Department of Neurology, University Hospital of Larissa, Faculty of Medicine, University of Thessaly, 41110 Larissa, Greece
| | | | - Efthimios Dardiotis
- Department of Neurology, University Hospital of Larissa, Faculty of Medicine, University of Thessaly, 41110 Larissa, Greece
| | - Vasileios Siokas
- Department of Neurology, University Hospital of Larissa, Faculty of Medicine, University of Thessaly, 41100 Larissa, Greece
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Werz O, Stettler H, Theurer C, Seibel J. The 125th Anniversary of Aspirin-The Story Continues. Pharmaceuticals (Basel) 2024; 17:437. [PMID: 38675399 PMCID: PMC11054228 DOI: 10.3390/ph17040437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Revised: 03/25/2024] [Accepted: 03/26/2024] [Indexed: 04/28/2024] Open
Abstract
The year 2024 marks the 125th anniversary of aspirin, still one of the most frequently used drugs worldwide. Despite its veritable age, it is still relevant in pharmacotherapy and its use has spread to new areas over time. Due to aspirin's multiple pharmacological actions unified in one single molecule (i.e., analgesic, antipyretic, anti-inflammatory, antithrombotic, and antiviral effects), it continues to attract considerable attention in the scientific community and is subject to intense basic and clinical research. In fact, recent results confirmed aspirin's potential role as an antiviral drug and as an agent that can block harmful platelet functions in inflammatory/immunological processes. These features may open up new horizons for this ancient drug. The future of aspirin looks, therefore, bright and promising. Aspirin is not yet ready for retirement; on the contrary, its success story continues. This 125th anniversary paper will concisely review the various therapeutic uses of aspirin with a particular emphasis on the latest research results and their implications (e.g., use as an antiviral agent). In addition, the reader is provided with future perspectives for this remarkable drug.
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Affiliation(s)
- Oliver Werz
- Department of Pharmaceutical/Medicinal Chemistry, Institute of Pharmacy, Friedrich Schiller University Jena, 07743 Jena, Germany;
| | - Hans Stettler
- Bayer Consumer Care AG, Peter Merian-Strasse 84, 4002 Basel, Switzerland;
| | - Christoph Theurer
- Bayer Vital GmbH, Kaiser-Wilhelm-Allee 70, 51373 Leverkusen, Germany;
| | - Jens Seibel
- Bayer Vital GmbH, Kaiser-Wilhelm-Allee 70, 51373 Leverkusen, Germany;
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Najmul Hejaz Azmi S, Aqib Nasir Al Rawahi W, Ibrahim Al Yahyai A, Ali Al Qasimi A, Saif Al Fuliti K, Said Al Qalhati O, Rahman N, Uddin Ahmed Q. High performance liquid chromatographic method optimized by Box-Behnken design model to determine caffeine in pharmaceutical preparations and urine samples. J Chromatogr B Analyt Technol Biomed Life Sci 2024; 1234:124035. [PMID: 38309045 DOI: 10.1016/j.jchromb.2024.124035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 01/19/2024] [Accepted: 01/24/2024] [Indexed: 02/05/2024]
Abstract
A UV-HPLC method optimized by Box-Behnken design model was developed to determine caffeine in pharmaceutical preparations and urine samples. The chromatographic conditions followed were mobile phase: methanol/water/ citrate buffer (pH 4.6) (40:25:35, v/v/v),AcclaimTMDionex C18 column (ODS 100A˚, 5 µm; 4.6 × 250 mm),flow rate (0.9 mL min-1), column temperature (30 °C) and UV-detection wavelength (204 nm). The chromatographic variables: pH (A), % methanol fraction (B), flow rate(C) and column temperature (D) were optimized at 50 μg mL-1caffeine using BBD model. The chromatogram resulted in the asymmetry factor (1.23), theoretical plate 13,786 and retention time (5.79 min). The proposed HPLC method's greenness point was assessed byAnalytical Eco-scale and found to be 78 (as per guidelines, ranked as excellent). The linearity was ranged from2.0 to 70 µg mL-1 with coefficient of correlation (r = 0.999) and detection limit of 0.19 µg mL-1. The proposedmethod was developed successfully and applied for the assay of active caffeine in pharmaceutical preparations and urine samples. The % recovery obtained by both (proposed and reference) methods ranged from 99.98 to 100.05 % followed the compliance (100 ± 2 %) with Canadian Health Protection regulatory guidelines. The performance of the proposed method was compared with published papers and found to be acceptable and superior. The proposed method was quite effective as the reference method, and hence can be used as an alternative method for the assay of active caffeine in pharmaceutical preparations and urine samples.
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Affiliation(s)
- Syed Najmul Hejaz Azmi
- Applied Sciences Department, College of Applied Sciences and Pharmacy, University of Technology and Applied Sciences-Muscat, P. O. Box 74, Al Khuwair 133, Oman.
| | - Wafa Aqib Nasir Al Rawahi
- Applied Sciences Department, College of Applied Sciences and Pharmacy, University of Technology and Applied Sciences-Muscat, P. O. Box 74, Al Khuwair 133, Oman.
| | - Arwa Ibrahim Al Yahyai
- Applied Sciences Department, College of Applied Sciences and Pharmacy, University of Technology and Applied Sciences-Muscat, P. O. Box 74, Al Khuwair 133, Oman.
| | - Asma Ali Al Qasimi
- Applied Sciences Department, College of Applied Sciences and Pharmacy, University of Technology and Applied Sciences-Muscat, P. O. Box 74, Al Khuwair 133, Oman.
| | - Kothar Saif Al Fuliti
- Applied Sciences Department, College of Applied Sciences and Pharmacy, University of Technology and Applied Sciences-Muscat, P. O. Box 74, Al Khuwair 133, Oman.
| | - Omayma Said Al Qalhati
- Applied Sciences Department, College of Applied Sciences and Pharmacy, University of Technology and Applied Sciences-Muscat, P. O. Box 74, Al Khuwair 133, Oman.
| | - Nafisur Rahman
- Department of Chemistry, Aligarh Muslim University, Aligarh 202002, Uttar Pradesh, India.
| | - Qamar Uddin Ahmed
- Department of Pharmaceutical Chemistry, Kulliyyah of Pharmacy, International Islamic University Malaysia, 25200, Kuantan, Pahang DM, Malaysia.
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Diener HC, Gaul C. [Drug therapy of the acute migraine attack and prophylaxis of migraine]. Dtsch Med Wochenschr 2023; 148:678-684. [PMID: 37216943 DOI: 10.1055/a-1857-3887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Migraine has a prevalence of 10 % in Germany, making it the most common neurological disorder. Migraine is a prevalent disorder not only for neurologist, it's an everyday topic for general physicians and internal medicine as well. Acute migraine attacks are treated with analgesics or triptans. In case of frequent migraine attacks, there is an indication for medicinal and non-pharmacological migraine prophylaxis. Medications include beta-blockers, flunarizine, anticonvulsants, amitriptyline or, in the case of chronic migraine, onabotulinumtoxinA. If these drugs are not effective, are not tolerated or contraindicated, monoclonal antibodies against calcitonin gene-related peptide (CGRP) or the CGRP receptor can be used.
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Ortiz MI. Synergistic interaction and activation of the opioid receptor-NO-cGMP-K + channel pathway on peripheral antinociception induced by the α-Bisabolol-diclofenac combination. Front Pharmacol 2023; 14:1158236. [PMID: 37124202 PMCID: PMC10133703 DOI: 10.3389/fphar.2023.1158236] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 04/06/2023] [Indexed: 05/02/2023] Open
Abstract
Introduction: The local peripheral combination of analgesic drugs with herbal derivatives may have beneficial effects. Information on the action mechanism of these interactions between drugs is scarce. Therefore, the main of the present study was to determine the pharmacological interaction and action mechanism of the combination α-Bisabolol and diclofenac. Methods: Rats were injected in the dorsal surface of the right hind paw with 1% formalin. Rats received subcutaneous injections in the dorsal surface of paw of vehicles or increasing doses of α-Bisabolol, diclofenac or their combination before formalin injection into the paw. Antinociception of the α-Bisabolol + diclofenac combination was evaluated with and without the local treatment of naloxone, metformin, NG-nitro-L-arginine methyl ester (L-NAME), 1H- (1,2,4)-oxadiazolo (4,2-a) quinoxalin-1-one (ODQ), glibenclamide, glipizide, 4-aminopyridine, tetraethylammonium, apamin, or charybdotoxin. Results: α-Bisabolol, diclofenac or α-Bisabolol-diclofenac combinations produced significant antinociception in the rat (p < 0.05). The experimental effective dose (ED) value of 109.2 µg/paw was different significantly of the theoretical effective dose (ED) of 245.7 µg/paw (synergism). Blockers significantly reverted the antinociception produced by the synergistic combination of α-Bisabolol and diclofenac. Discussion: Data showed a synergism of the α-Bisabolol-diclofenac combination and the activation of the opioid receptor-Nitric Oxide-cyclic GMP-K+ channels pathway and a biguanide-dependent mechanism in order to produce the potentiation of its peripheral antinociception in the formalin test.
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Wahab S, Kataria S, Woolley P, O'Hene N, Odinkemere C, Kim R, Urits I, Kaye AD, Hasoon J, Yazdi C, Robinson CL. Literature Review: Pericranial Nerve Blocks for Chronic Migraines. Health Psychol Res 2023; 11:74259. [PMID: 37139462 PMCID: PMC10151122 DOI: 10.52965/001c.74259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/05/2023] Open
Abstract
Purpose of Review Headaches, especially migraines, are one of the most pervasive neurological disorders affecting up to 15.9% of the population. Current methods of migraine treatment include lifestyle changes, pharmacologic, and minimally invasive techniques such as peripheral nerve stimulation (PNS) and pericranial nerve blocks (PNB). Recent Findings PNBs are used to treat and prevent migraines and involves injection of local anesthetics with or without corticosteroids. PNBs include the greater occipital, supraorbital, supratrochlear, lesser occipital, auriculotemporal, sphenopalantine ganglion, and cervical root nerve blocks. Of the PNBs, the most extensively studied is the greater occipital nerve block (GONB) which has been shown to be an efficacious treatment for migraines, trigeminal neuralgia, hemi-crania continua, and post-lumbar puncture, post-concussive, cluster, and cervicogenic headaches but not medication overuse and chronic tension type headaches. Summary In this review, we aim to summarize the recent literature on PNBs and their efficacy in the treatment of migraines including a brief discussion of peripheral nerve stimulation.
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Affiliation(s)
- Stephanie Wahab
- Beth Israel Deaconess Medical Center, Department of Anesthesiology, Critical Care, and Pain Medicine, Boston, MA
| | - Saurabh Kataria
- Louisiana State University Health Shreveport, Department of Neurology, Shreveport, LA
| | - Parker Woolley
- Beth Israel Deaconess Medical Center, Department of Anesthesiology, Critical Care, and Pain Medicine, Boston, MA
| | - Naanama O'Hene
- Beth Israel Deaconess Medical Center, Department of Anesthesiology, Critical Care, and Pain Medicine, Boston, MA
| | - Chima Odinkemere
- Beth Israel Deaconess Medical Center, Department of Anesthesiology, Critical Care, and Pain Medicine, Boston, MA
| | - Rosa Kim
- Georgetown University Hospital, Department of General Surgery, Medstar, Washington, DC
| | | | - Alan D Kaye
- Louisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA
| | - Jamal Hasoon
- UTHealth McGovern Medical School, Department of Anesthesiology, Critical Care and Pain Medicine, Houston, TX
| | - Cyrus Yazdi
- Beth Israel Deaconess Medical Center, Department of Anesthesiology, Critical Care, and Pain Medicine, Boston, MA
| | - Christopher L Robinson
- Beth Israel Deaconess Medical Center, Department of Anesthesiology, Critical Care, and Pain Medicine, Boston, MA
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Trouvin AP, Attal N, Perrot S. Lifestyle and chronic pain: double jeopardy? Br J Anaesth 2022; 129:278-281. [PMID: 35803752 DOI: 10.1016/j.bja.2022.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 06/02/2022] [Accepted: 06/07/2022] [Indexed: 11/26/2022] Open
Abstract
Given the often disappointing results of pharmacotherapy, many patients with chronic pain seek to modify their lifestyle. Some lifestyle factors, such as the consumption of alcohol, tobacco, cannabis, or psychostimulants, are deleterious in this context, whereas others, such as physical activity and a balanced diet, are considered beneficial, but these require substantial effort on the part of patients. In all cases, it is important to analyse lifestyle factors in patients with chronic pain, without stigmatisation, as the co-existence of pain and inappropriate behaviour can be seen as double jeopardy in patients with pain.
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Affiliation(s)
- Anne-Priscille Trouvin
- Centre d'Evaluation et de Traitement de la Douleur, Hôpital Cochin, Université Paris Cité, INSERM U987, Paris, France; CETD and INSERM U987, Hôpital Ambroise Paré, Boulogne-Billancourt, France; Paris Saclay University, Versailles, France
| | - Nadine Attal
- CETD and INSERM U987, Hôpital Ambroise Paré, Boulogne-Billancourt, France; Paris Saclay University, Versailles, France
| | - Serge Perrot
- Centre d'Evaluation et de Traitement de la Douleur, Hôpital Cochin, Université Paris Cité, INSERM U987, Paris, France; CETD and INSERM U987, Hôpital Ambroise Paré, Boulogne-Billancourt, France.
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Temirak A, Schlegel JG, Voss JH, Vaaßen VJ, Vielmuth C, Claff T, Müller CE. Irreversible Antagonists for the Adenosine A 2B Receptor. Molecules 2022; 27:molecules27123792. [PMID: 35744918 PMCID: PMC9231011 DOI: 10.3390/molecules27123792] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 06/05/2022] [Accepted: 06/07/2022] [Indexed: 11/16/2022] Open
Abstract
Blockade of the adenosine A2B receptor (A2BAR) represents a potential novel strategy for the immunotherapy of cancer. In the present study, we designed, synthesized, and characterized irreversible A2BAR antagonists based on an 8-p-sulfophenylxanthine scaffold. Irreversible binding was confirmed in radioligand binding and bioluminescence resonance energy transfer(BRET)-based Gα15 protein activation assays by performing ligand wash-out and kinetic experiments. p-(1-Propylxanthin-8-yl)benzene sulfonyl fluoride (6a, PSB-21500) was the most potent and selective irreversible A2BAR antagonist of the present series with an apparent Ki value of 10.6 nM at the human A2BAR and >38-fold selectivity versus the other AR subtypes. The corresponding 3-cyclopropyl-substituted xanthine derivative 6c (PSB-21502) was similarly potent, but was non-selective versus A1- and A2AARs. Attachment of a reactive sulfonyl fluoride group to an elongated xanthine 8-substituent (12, Ki 7.37 nM) resulted in a potent, selective, reversibly binding antagonist. Based on previous docking studies, the lysine residue K2697.32 was proposed to react with the covalent antagonists. However, the mutant K269L behaved similarly to the wildtype A2BAR, indicating that 6a and related irreversible A2BAR antagonists do not interact with K2697.32. The new irreversible A2BAR antagonists will be useful tools and have the potential to be further developed as therapeutic drugs.
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Calandre EP, Slim M, Rico-Villademoros F. How does a physician decide which pharmacotherapeutic option to select for acute migraine attacks? Expert Opin Pharmacother 2022; 23:1129-1133. [PMID: 35382662 DOI: 10.1080/14656566.2022.2060740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Elena P Calandre
- Instituto de Neurociencias, Universidad de Granada, Armilla, Spain
| | - Mahmoud Slim
- Instituto de Neurociencias, Universidad de Granada, Armilla, Spain
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Ashina H, Dodick DW. Post-traumatic Headache: Pharmacologic Management and Targeting CGRP Signaling. Curr Neurol Neurosci Rep 2022; 22:105-111. [PMID: 35138589 DOI: 10.1007/s11910-022-01175-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/01/2021] [Indexed: 12/29/2022]
Abstract
PURPOSE OF REVIEW Post-traumatic headache is a common sequela of injury to the head and/or neck. Here, we review the current approach to pharmacologic management of post-traumatic headache and explore the therapeutic promise of targeting calcitonin gene-related peptide signaling to address unmet treatment needs. RECENT FINDINGS The scarcity of data from controlled trials has left clinicians to rely on mainly expert opinion for the pharmacologic management of post-traumatic headache. The current view is that a phenotype-guided approach should be used, in which patients are treated according to the primary headache phenotype that their clinical features resemble the most (e.g. migraine, tension-type headache). Moreover, incremental advances are being made in the field that aim to identify possible cellular and molecular drivers of headache persistence. Calcitonin gene-related peptide has emerged as a key drug target which, in turn, has prompted novel insights on the potential importance of early initiation of pharmacologic treatment following the onset of post-traumatic headache. This, in turn, might prevent subsequent persistence and chronification of headache.
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Affiliation(s)
- Håkan Ashina
- Danish Headache Center, Department of Neurology, Faculty of Health and Medical Sciences, Rigshospitalet Glostrup, University of Copenhagen, Copenhagen, Denmark
- Department of Neurorehabilitation/Traumatic Brain Injury, Rigshospitalet, Copenhagen, Denmark
| | - David W Dodick
- Department of Neurology, Mayo Clinic, Scottsdale, AZ, USA.
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