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Open Access 01-12-2021 | Cluster Headache | Research article

Effectiveness of medication in cluster headache

Authors: Johannes Drescher, Andreas Khouri, Tina Katharina Amann, Charly Gaul, Peter Kropp, Yannic Siebenhaar, Jörg Scheidt

Published in: BMC Neurology | Issue 1/2021

Abstract

Background

The aim of this work is to analyze the reports on cluster headache attacks collected online in the citizen science project CLUE with respect to the effectiveness of drugs taken during the attacks. The collection of data within the framework of citizen science projects opens up the possibility of investigating the effectiveness of acute medication on the basis of a large number of individual attacks instead of a simple survey of patients.

Methods

Data from 8369 cluster headache attacks, containing information about acute medication taken and the assessment of its effect, were collected from 133 participants using an online platform and a smartphone app. Chi-square tests were used to investigate whether the effect of the three recommended acute drugs differs when distinguishing between participants with chronic or episodic cluster headache. Furthermore, it was investigated whether there are differences between smokers and non-smokers in the assessment of the effect of the acute medication.

Results

Our participants rated the effectiveness of sumatriptan 6 mg s.c. as significantly better than oxygen and zolmitriptan nasal spray. Oxygen is considered to be significantly better in episodic versus chronic cluster headache, and sumatriptan is considered to be significantly better in chronic versus episodic cluster headache. Smokers rate the effect of oxygen as significantly better than non-smokers.

Conclusions

Despite some methodological limitations, web-based data collection is able to support findings from clinical trials in a real world setting about effectiveness of acute cluster headache treatment in several situations.

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Gooriah R, Buture A, Ahmed F. Evidence-based treatments for cluster headache. Ther Clin Risk Manag. 2015;11:1687–96. https://doi.org/10.2147/TCRM.S94193.CrossRefPubMedPubMedCentral

Headache Classification Committee of the International Headache Society (IHS). The international classification of headache disorders, 3rd edition (beta version). Cephalalgia. 2013;33(9):629–808. https://doi.org/10.1177/0333102413485658.CrossRef

The Sumatriptan Cluster Headache Study Group. Treatment of acute cluster headache with sumatriptan. N Engl J Med. 1991;325(5):322–6. https://doi.org/10.1056/NEJM199108013250505.CrossRef

Cittadini E, May A, Straube A, Evers S, Bussone G, Goadsby PJ. Effectiveness of intranasal zolmitriptan in acute cluster headache: a randomized, placebo-controlled, double-blind crossover study. Arch Neurol. 2006;63(11):1537–42. https://doi.org/10.1001/archneur.63.11.nct60002.CrossRefPubMed

Cohen AS, Burns B, Goadsby PJ. High-flow oxygen for treatment of cluster headache: a randomized trial. JAMA. 2009;302(22):2451–7. https://doi.org/10.1001/jama.2009.1855.CrossRefPubMed

Bahra A, Gawel MJ, Hardebo JE, Millson D, Breen SA, Goadsby PJ. Oral zolmitriptan is effective in the acute treatment of cluster headache. Neurology. May 2000;54(9):1832–9. https://doi.org/10.1212/WNL.54.9.1832.CrossRefPubMed

Gobel H, Lindner V, Heinze A, Ribbat M, Deuschl G. Acute therapy for cluster headache with sumatriptan: findings of a one-year-long-term study. Neurology. 1998;51(3):908–11. https://doi.org/10.1212/WNL.51.3.908.CrossRefPubMed

Millson DS. How effective are triptans in the treatment of episodic and chronic cluster headache. Ital J Neurol Sci. 1999;20(2 Suppl):S69–71. https://doi.org/10.1007/pl00015006.CrossRefPubMed

Schindler EAD, Wright DA, Weil MJ, Gottschalk CH, Pittman BP, Sico JJ. Survey analysis of the use, effectiveness, and patient-reported tolerability of inhaled oxygen compared with injectable sumatriptan for the acute treatment of cluster headache. Headache. 2018;58(10):1568–78. https://doi.org/10.1111/head.13405.CrossRefPubMed

10.

Schürks M, Kurth T, de Jesus J, et al. Cluster headache: clinical presentation, lifestyle features, and medical treatment. Headache. 2006;46(8):1246–54. https://doi.org/10.1111/j.1526-4610.2006.00534.x.CrossRefPubMed

11.

Heatherton TF, Kozlowski LT, Frecker RC, Fagerstrom KO. The fagerstrom test for nicotine dependence: a revision of the fagerstrom tolerance questionnaire. Br J Addict. 1991;86(9):1119–27. https://doi.org/10.1111/j.1360-0443.1991.tb01879.x.CrossRefPubMed

12.

Pomerleau CS, Majchrezak MI, Pomerleau OF. Nicotine dependence and the Fagerstrom tolerance questionnaire: a brief review. J Subst Abus. 1989;1(4):471–7. https://doi.org/10.1016/S0899-3289(20)30011-0.CrossRef

13.

Wogenstein F, Gaul C, Kropp P, Scheidt J, Siebenhaar Y, Drescher J. Design and implementation of a platform for the citizen science project migraine radar. IT. 2018;60(1):11–9.

14.

Hawker GA, Mian S, Kendzerska T, French M. Measures of adult pain: Visual Analog Scale for Pain (VAS Pain), Numeric Rating Scale for Pain (NRS Pain), McGill Pain Questionnaire (MPQ), Short-Form McGill Pain Questionnaire (SFMPQ), Chronic Pain Grade Scale (CPGS), Short Form-36 Bodily Pain Scale (SF-36 BPS) and Measure of Intermittent and Constant Osteoarthritis Pain (ICOAP). Arthritis Care Res. 2011;63(S11):240–52.CrossRef

15.

R Core Team. R: a language and environment for statistical computing. Vienna: R Foundation for Statistical Computing; 2017. https://www.R-project.org

16.

Pearson SM, Burish MJ, Shapiro RE, Yan Y, Schor LI. Effectiveness of oxygen and other acute treatments for cluster headache: results from the cluster headache questionnaire, an international survey. Headache. 2019;59(2):235–49. https://doi.org/10.1111/head.13473.CrossRefPubMedPubMedCentral

17.

Fagerström K, Furberg H. A comparison of the fagerström test for nicotine dependence and smoking prevalence across countries. Addiction. 2008;103(5):841–5. https://doi.org/10.1111/j.1360-0443.2008.02190.x.CrossRefPubMedPubMedCentral

18.

Lampert T, von der Lippe E, Müters S. Verbreitung des Rauchens in der Erwachsenenbevölkerung in Deutschland: Ergebnisse der Studie zur Gesundheit Erwachsener in Deutschland (DEGS1) [Prevalence of smoking in the adult population of Germany: results of the German Health Interview and Examination Survey for Adults (DEGS1)]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2013;56(5-6):802–8. German. https://doi.org/10.1007/s00103-013-1698-1.

Title: Effectiveness of medication in cluster headache
Authors: Johannes Drescher
Andreas Khouri
Tina Katharina Amann
Charly Gaul
Peter Kropp
Yannic Siebenhaar
Jörg Scheidt
Publication date: 01-12-2021
Publisher: BioMed Central
Keywords: Cluster Headache
Triptan Drugs
Sumatriptan
Zolmitriptan
Published in: BMC Neurology / Issue 1/2021
Electronic ISSN: 1471-2377
DOI: https://doi.org/10.1186/s12883-021-02195-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Effectiveness of medication in cluster headache

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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