PT  - JOURNAL ARTICLE
AU  - Chuanjie Wu
AU  - Dongsheng Guan
AU  - Ming Ren
AU  - Zhengfei Ma
AU  - Changming Wan
AU  - Yinglin Cui
AU  - Ping Zhong
AU  - Wenbo Zhao
AU  - Chuanhui Li
AU  - Feng Yan
AU  - Jinqiu Xie
AU  - Fang Xue
AU  - Yajun Lian
AU  - Hongbo Liu
AU  - Cui Wang
AU  - Xunming Ji
AU  - Nanchang Xie
TI  - Aminophylline for treatment of postdural puncture headache
AID  - 10.1212/WNL.0000000000005351
DP  - 2018 Apr 24
TA  - Neurology
PG  - e1523--e1529
VI  - 90
IP  - 17
4099  - http://n.neurology.org/content/90/17/e1523.short
4100  - http://n.neurology.org/content/90/17/e1523.full
SO  - Neurology2018 Apr 24; 90
AB  - Objective To investigate the efficacy and safety of IV aminophylline for patients with postdural puncture headache (PDPH).Methods We randomly assigned patients to groups receiving either 250 mg IV aminophylline or a placebo within 3 hours of symptom onset once daily for 2 consecutive days. The primary endpoint was headache severity 8 hours after treatment. We assessed this using visual analog scale (VAS) scores taken from patients in a standing position. We also recorded posttreatment VAS score changes, Patient Global Impression of Change (PGIC) scores, and adverse events. We performed an intention-to-treat analysis.Results We enrolled 126 patients with PDPH at 5 centers in China (62 assigned to the aminophylline group and 64 to the placebo group). The median age was 37 years, and 96 (76.2%) patients were women. Compared to the placebo-treated patients, the aminophylline-treated patients had significantly lower mean VAS scores 8 hours after treatment (5.34 vs 2.98, p < 0.001) and were significantly more likely to report improvements on the PGIC (39.1% vs 72.6%, p < 0.01). This therapeutic effect was already evident at the 30-minute time point and persisted for 2 days. There was no significant difference in the incidence of adverse events (4.8% vs 1.6%, p = 0.589).Conclusions IV aminophylline is an effective and safe early-stage treatment for patients with PDPH.ClinicalTrials.gov identifier NCT02522013.Classification of evidence This study provides Class I evidence that for people with PDPH, IV aminophylline reduces headache severity.EBP=epidural blood patch; PDPH=postdural puncture headache; PGIC=Patient Global Impression of Change; VAS=visual analog scale