RT Journal Article
SR Electronic
T1 Aminophylline for treatment of postdural puncture headache
JF Neurology
JO Neurology
FD Lippincott Williams & Wilkins
SP e1523
OP e1529
DO 10.1212/WNL.0000000000005351
VO 90
IS 17
A1 Wu, Chuanjie
A1 Guan, Dongsheng
A1 Ren, Ming
A1 Ma, Zhengfei
A1 Wan, Changming
A1 Cui, Yinglin
A1 Zhong, Ping
A1 Zhao, Wenbo
A1 Li, Chuanhui
A1 Yan, Feng
A1 Xie, Jinqiu
A1 Xue, Fang
A1 Lian, Yajun
A1 Liu, Hongbo
A1 Wang, Cui
A1 Ji, Xunming
A1 Xie, Nanchang
YR 2018
UL http://n.neurology.org/content/90/17/e1523.abstract
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