1,721,315 research outputs found
Comments and supporting arguments concerning the ,,OFF-LABEL USE" in the treatment of headache
No full textEfficacy and safety of monoclonal antibodies targeting CGRP in migraine prevention. GRADE tables elaborated by the ad hoc working group of the International Headache Society
No full textObjectives: Grading of Recommendations, Assessment Development and Evaluation (GRADE) tables were created using a standardized and independent assessment of the efficacy and side effects of treatments with monoclonal antibodies (mAb) against calcitonin gene-related peptide (CGRP) or the CGRP receptor for the prevention of migraine. We hope to provide support for author groups writing national or regional treatment or management guidelines for migraine prevention. Methods: We formulated patient/population, intervention, comparison and outcomes (PICO) questions for the efficacy and safety of mAb against CGRP or the CGRP-receptor for the prevention of migraine attacks. We performed a systematic literature research for randomized studies with eptinezumab, erenumab, fremanezumab and galcanezumab and a pooled analysis was done, using RevMan 5.4 software. For dichotomous outcomes we used risk ratio, and for continuous outcomes we used the mean difference to compare and summarize the evidence between groups. The evidence across studies, for each outcome, except serious adverse events, was assessed using GRADE evidence tables. Additionally, we report the serious adverse effects in the tables of the characteristics of the studies. Results: All mAb are superior to placebo for the reduction in monthly migraine days (days in which a headache consistent with migraine occurred) in participants with episodic and chronic migraine. There are no major differences between the mAb. Conclusions: The GRADE evidence summary tables provided will support author groups to write treatment guidelines for the prevention of migraine with mAb
Response to the letter by Dame
No full textIn his letter, Christof Dame1 builds on and supports the points made in the discussion part of our recent erythropoietin (EPO) stroke article.2 Especially the exploratory analysis presented in this article, showing potential beneficial effects of EPO treatment in patients nonqualifying for recombinant tissue plasminogen activator (rtPA),2,3⇓ should definitely stimulate further basic research to better understand and define potential contraindications to EPO treatment for future EPO stroke trials. For this purpose, we decided to share with your readers a new set of data obtained during our extensive post hoc evaluation of the study that might give additional insight into the risk profile of EPO treatment
Pain treatment facilities at hospitals in Germany. Outpatient, daycare and inpatient facilities for patients with chronic pain
No full textSpecialised pain treatment is available at inpatient, daycare and outpatient units at hospitals in Germany. A total of 579 hospitals in Germany offer at least one of the three pain treatment options. The main treatment involves outpatient care, but inpatient wards and daycare institutions have become more common. The type and number of pain treatment facilities differ regionally. Five of the 16 counties do not officially offer inpatient care at all, although pain treatment sites have been opened on the initiative of the hospitals themselves. Since specialised pain treatment is insufficiently defined by diagnosis (ICD-10) or procedures (OPS) in the German DRG system, it is not possible to recognise its availability when the facilities are not officially named. Pain treatment should be differentiated dependent on whether patients are treated within a single area of expertise or by specialised multiprofessional pain facilities. At hospitals, systematic multimodal pain treatment is possible. Inpatient and daycare pain treatment programs are suitable when outpatient treatment has failed. An overview of the pain therapies offered is a prerequisite for their optimal use,the demonstration of their necessity and for their continued development throughout Germany. This study was planned and supervised by the commission for quality assurance of the German IASP chapter and was sponsored by the German IASP chapter
Therapie der Migräneattacke und Prophylaxe Migräne – Leitlinien für Diagnostik und Therapie in der Neurologie
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