TY -的T1 -随机试验比较低- vs第四大剂量地塞米松中度到重度患者偏头痛JF -神经学乔-神经- 10.1212 / WNL。首页0000000000207648 SP - 10.1212 / WNL。0000000000207648 AU -本杰明·W·弗里德曼盟Clemencia Solorzano AU -本杰明·d·凯斯勒盟克里斯蒂娜Martorello AU -卡洛L Lutz AU -卡门·菲AU -妮可·阿德勒AU -希拉里·莫斯盟达内尔凯恩盟-伊瑞艾迪Y1 - 2023/08/21 UR - //www.ez-admanager.com/content/early/2023/08/21/WNL.0000000000207648.abstract N2 -背景。首页地塞米松减少偏头痛的频率急诊科(ED)出院后复发。然而,最佳剂量的地塞米松是未知的。我们假设地塞米松16毫克IV将允许利率持续减缓头痛超过4毫克当与胃复安10毫克IV.Methods流行性流感减毒活疫苗。这是一个随机双盲研究。成年人面对ICHD3偏头痛头痛会议标准是合格的,如果他们认为中度或严重的头痛强度。疼痛强度评估ED长达两个小时,48小时内通过电话,7天后。主要结果是持续头痛缓解。二次结果包括头痛缓解两小时内和在随后的一周的头痛天数。 Relying on a priori criteria, the data safety monitoring committee recommended halting the study early for futility.Results. 1823 patients were screened and 209 were randomized. The mean age was 38 years (SD- 11). 179/209 (86%) identified as women. 151/209 (72%) of the population reported severe intensity; the rest reported moderate. 35/102 (34%) participants in the metoclopramide +4mg arm achieved sustained headache relief as did 42/102 (41%) of participants in the metoclopramide +16mg arm (95%CI for absolute difference of 7%: -6, 20%). Headache relief within two hours occurred in 77/104 (74%) low dose and 82/ 105 (78%) high dose participants (95%CI for absolute difference of 4% = -8, 16%). During the week after ED discharge, low dose participants reported a median of 2 headache days (25th, 75th percentile: 1,5); in the high dose arm this was also 2 (25th, 75th percentile: 0,4) (95%CI for mean difference of 0.4: -0.3, 1.2).Conclusions. When added to 10mg IV metoclopramide, doses of dexamethasone greater than 4mg are unlikely to benefit patients in the ED with migraine.Trial registration information. This study was registered at clinicaltrials.govon Oct 2, 2019 (NCT04112823). The first patient was enrolled Dec 22, 2019.Classification of evidence. This study provides Class 1 evidence that 16mg of IV dexamethasone is unlikely to provide greater rates of sustained headache relief than 4mg of IV dexamethasone among patients in the ED with migraine treated concurrently with IV metoclopramide. ER -