Quelle:
Cochrane
Database Syst Rev. 2010
Apr 14
Migränebehandlung
mit ASS:
Eine
von der Cochrane-Organisation initiierte Analyse
von 13 wissenschaftlichen Studien mit über
4.000 Teilnehmern zeigte, dass die Einnahme
von Azetylsalizylsäure (ASS= u.a. Aspirin)
akute Migräne-Kopfschmerzen ähnlich gut lindert
wie das Standardmedikament Sumatriptan.
ASS stellt damit
eine sehr kostengünstige Alternative zur derzeitigen
Standard-Migränetherapie dar. Durch die Zugabe
des auf die Darmbeweglichkeit einwirkenden
Wirkstoffs Metoclopramid kann bei Migräneanfällen
auch die begleitende Übelkeit deutlich gebessert
werden. Die beobachteten Nebenwirkungen der
ASS-Therapie sind leicht und dauern nur kurze
Zeit an.
ASS wird dabei besser vertragen als das viel
teurere Sumatriptan.
zur
Originalquelle
hier (englische Sprache)
Cochrane Database Syst Rev. 2010 Apr 14;4:CD008041.
Aspirin
with or without an antiemetic for acute migraine headaches
in adults.
Kirthi V, Derry
S, Moore
RA, McQuay
HJ. Pain Research and Nuffield Department of Anaesthetics,
University of Oxford, West Wing (Level 6), John Radcliffe
Hospital, Oxford, Oxfordshire, UK, OX3 9DU.
Abstract
BACKGROUND:
Migraine is a common, disabling condition and a burden for
the individual, health services and society. Many sufferers
choose not to, or are unable to, seek professional help
and rely on over-the-counter analgesics. Co-therapy with
an antiemetic should help to reduce nausea and vomiting
commonly associated with migraine headaches.
OBJECTIVES:
To determine the efficacy and tolerability of aspirin, alone
or in combination with an antiemetic, compared to placebo
and other active interventions in the treatment of acute
migraine headaches in adults.
SEARCH
STRATEGY: We searched Cochrane CENTRAL, MEDLINE, EMBASE
and the Oxford Pain Relief Database for studies through
10 March 2010.
SELECTION
CRITERIA: We included randomised, double-blind, placebo-
or active-controlled studies using aspirin to treat a discrete
migraine headache episode, with at least 10 participants
per treatment arm.
DATA
COLLECTION AND ANALYSIS: Two review authors independently
assessed trial quality and extracted data. Numbers of participants
achieving each outcome were used to calculate relative risk
and numbers needed to treat (NNT) or harm (NNH) compared
to placebo or other active treatment. MAIN RESULTS: Thirteen
studies (4222 participants) compared aspirin 900 mg or 1000
mg, alone or in combination with metoclopramide 10 mg, with
placebo or other active comparators, mainly sumatriptan
50 mg or 100 mg. For all efficacy outcomes, all active treatments
were superior to placebo, with NNTs of 8.1, 4.9 and 6.6
for 2-hour pain-free, 2-hour headache relief, and 24-hour
headache relief with aspirin alone versus placebo, and 8.8,
3.3 and 6.2 with aspirin plus metoclopramide versus placebo.
Sumatriptan 50 mg did not differ from aspirin alone for
2-hour pain-free and headache relief, while sumatriptan
100 mg was better than the combination of aspirin plus metoclopramide
for 2-hour pain-free, but not headache relief; there were
no data for 24-hour headache relief. Associated symptoms
of nausea, vomiting, photophobia and phonophobia were reduced
with aspirin compared with placebo, with additional metoclopramide
significantly reducing nausea (P < 0.00006) and vomiting
(P = 0.002) compared with aspirin alone.Fewer participants
needed rescue medication with aspirin than with placebo.
Adverse events were mostly mild and transient, occurring
slightly more often with aspirin than placebo.
AUTHORS'
CONCLUSIONS: Aspirin 1000 mg is an effective treatment for
acute migraine headaches, similar to sumatriptan 50 mg or
100 mg. Addition of metoclopramide 10 mg improves relief
of nausea and vomiting. Adverse events were mainly mild
and transient, and were slightly more common with aspirin
than placebo, but less common than with sumatriptan 100
mg.
PMID:
20393963 [PubMed - indexed for MEDLINE]
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