Skip to main content
Top
Published in: BMC Neurology 1/2013

Open Access 01-12-2013 | Study protocol

Study protocol of Prednisone in episodic Cluster Headache (PredCH): a randomized, double-blind, placebo-controlled parallel group trial to evaluate the efficacy and safety of oral prednisone as an add-on therapy in the prophylactic treatment of episodic cluster headache with verapamil

Authors: Dagny Holle, Jan Burmeister, André Scherag, Claudia Ose, Hans-Christoph Diener, Mark Obermann

Published in: BMC Neurology | Issue 1/2013

Login to get access

Abstract

Background

Episodic cluster headache (ECH) is a primary headache disorder that severely impairs patient’s quality of life. First-line therapy in the initiation of a prophylactic treatment is verapamil. Due to its delayed onset of efficacy and the necessary slow titration of dosage for tolerability reasons prednisone is frequently added by clinicians to the initial prophylactic treatment of a cluster episode. This treatment strategy is thought to effectively reduce the number and intensity of cluster attacks in the beginning of a cluster episode (before verapamil is effective). This study will assess the efficacy and safety of oral prednisone as an add-on therapy to verapamil and compare it to a monotherapy with verapamil in the initial prophylactic treatment of a cluster episode.

Methods and design

PredCH is a prospective, randomized, double-blind, placebo-controlled trial with parallel study arms. Eligible patients with episodic cluster headache will be randomized to a treatment intervention with prednisone or a placebo arm. The multi-center trial will be conducted in eight German headache clinics that specialize in the treatment of ECH.

Discussion

PredCH is designed to assess whether oral prednisone added to first-line agent verapamil helps reduce the number and intensity of cluster attacks in the beginning of a cluster episode as compared to monotherapy with verapamil.

Trial registration

German Clinical Trials Register DRKS00004716
Appendix
Available only for authorised users
Literature
1.
go back to reference Headache Classification Subcommittee of the International Headache Society: The international classification of headache disorders: 2nd edition. Cephalalgia. 2004, 24: 9-160.CrossRef Headache Classification Subcommittee of the International Headache Society: The international classification of headache disorders: 2nd edition. Cephalalgia. 2004, 24: 9-160.CrossRef
2.
go back to reference May A, Leone M, Afra J, Linde M, Sándor PS, Evers S, Goadsby PJ: EFNS guidelines on the treatment of cluster headache and other trigeminal-autonomic cephalalgias. Eur J Neurol. 2006, 13 (10): 1066-1077. 10.1111/j.1468-1331.2006.01566.x.CrossRefPubMed May A, Leone M, Afra J, Linde M, Sándor PS, Evers S, Goadsby PJ: EFNS guidelines on the treatment of cluster headache and other trigeminal-autonomic cephalalgias. Eur J Neurol. 2006, 13 (10): 1066-1077. 10.1111/j.1468-1331.2006.01566.x.CrossRefPubMed
3.
go back to reference May A, Evers S, Straube A, Pfaffenrath V, Diener HC: Treatment and prophylaxis for cluster headaches and other trigeminal autonomic headaches. Revised recommendations of the German Migraine and Headache Society. Schmerz. 2005, 19 (3): 225-241. 10.1007/s00482-005-0397-8.CrossRefPubMed May A, Evers S, Straube A, Pfaffenrath V, Diener HC: Treatment and prophylaxis for cluster headaches and other trigeminal autonomic headaches. Revised recommendations of the German Migraine and Headache Society. Schmerz. 2005, 19 (3): 225-241. 10.1007/s00482-005-0397-8.CrossRefPubMed
4.
go back to reference Gaul C, Diener HC, Müller OM: Cluster headache: clinical features and therapeutic options. Dtsch Arztebl Int. 2011, 108 (33): 543-549.PubMedPubMedCentral Gaul C, Diener HC, Müller OM: Cluster headache: clinical features and therapeutic options. Dtsch Arztebl Int. 2011, 108 (33): 543-549.PubMedPubMedCentral
5.
go back to reference Leone M, D’Amico D, Frediani F, Moschiano F, Grazzi L, Attanasio A, Bussone G: Verapamil in the prophylaxis of episodic cluster headache: a double-blind study versus placebo. Neurology. 2000, 54 (6): 1382-1385. 10.1212/WNL.54.6.1382.CrossRefPubMed Leone M, D’Amico D, Frediani F, Moschiano F, Grazzi L, Attanasio A, Bussone G: Verapamil in the prophylaxis of episodic cluster headache: a double-blind study versus placebo. Neurology. 2000, 54 (6): 1382-1385. 10.1212/WNL.54.6.1382.CrossRefPubMed
6.
go back to reference Antonaci F, Costa A, Candeloro E, Sjaastad O, Nappi G: Single high-dose steroid treatment in episodic cluster headache. Cephalalgia. 2005, 25 (4): 290-295. 10.1111/j.1468-2982.2004.00855.x.CrossRefPubMed Antonaci F, Costa A, Candeloro E, Sjaastad O, Nappi G: Single high-dose steroid treatment in episodic cluster headache. Cephalalgia. 2005, 25 (4): 290-295. 10.1111/j.1468-2982.2004.00855.x.CrossRefPubMed
7.
go back to reference Couch JR, Ziegler DK: Prednisone therapy for cluster headache. Headache. 1978, 18 (4): 219-221. 10.1111/j.1526-4610.1978.hed1804219.x.CrossRefPubMed Couch JR, Ziegler DK: Prednisone therapy for cluster headache. Headache. 1978, 18 (4): 219-221. 10.1111/j.1526-4610.1978.hed1804219.x.CrossRefPubMed
8.
go back to reference Jammes JL: The treatment of cluster headaches with prednisone. Dis Nerv Syst. 1975, 36 (7): 375-376.PubMed Jammes JL: The treatment of cluster headaches with prednisone. Dis Nerv Syst. 1975, 36 (7): 375-376.PubMed
9.
go back to reference Kudrow L: Comparative results of prednisone, methysergid, and lithium therapy in cluster headache. Current Concepts in Migraine Research. Edited by: Green R. 1978, New York: Raven, 1-196. Kudrow L: Comparative results of prednisone, methysergid, and lithium therapy in cluster headache. Current Concepts in Migraine Research. Edited by: Green R. 1978, New York: Raven, 1-196.
10.
go back to reference Mir P, Alberca R, Navarro A, Montes E, Martínez E, Franco E, Cayuela A, Lozano P: Prophylactic treatment of episodic cluster headache with intravenous bolus of methylprednisolone. Neurol Sci. 2003, 24 (5): 318-321. 10.1007/s10072-003-0182-3.CrossRefPubMed Mir P, Alberca R, Navarro A, Montes E, Martínez E, Franco E, Cayuela A, Lozano P: Prophylactic treatment of episodic cluster headache with intravenous bolus of methylprednisolone. Neurol Sci. 2003, 24 (5): 318-321. 10.1007/s10072-003-0182-3.CrossRefPubMed
11.
go back to reference Reija G, Nider G, Koscica N, Negro C, Musco G: Dexamethasone in the treatment of episodic cluster headaches: an open study of 18 patients. Funct Neurol. 1998, 13: 171-172. Reija G, Nider G, Koscica N, Negro C, Musco G: Dexamethasone in the treatment of episodic cluster headaches: an open study of 18 patients. Funct Neurol. 1998, 13: 171-172.
12.
go back to reference Krabbe A, Steiner TJ: Prophylactic treatment of cluster headache. Cluster headache syndrome in general practice. Basic concepts. Edited by: Sjaastad O, Giuseppe N. 2000, London: Smith-Gordon, 91-96. Krabbe A, Steiner TJ: Prophylactic treatment of cluster headache. Cluster headache syndrome in general practice. Basic concepts. Edited by: Sjaastad O, Giuseppe N. 2000, London: Smith-Gordon, 91-96.
13.
go back to reference Duvoisin RC: The cluster headache. JAMA. 1972, 222 (11): 1403-1404. 10.1001/jama.1972.03210110043010.CrossRefPubMed Duvoisin RC: The cluster headache. JAMA. 1972, 222 (11): 1403-1404. 10.1001/jama.1972.03210110043010.CrossRefPubMed
14.
go back to reference Friedman AP, Mikropoulos HE: Cluster headaches. Neurology. 1958, 8 (9): 653-663. 10.1212/WNL.8.9.653.CrossRefPubMed Friedman AP, Mikropoulos HE: Cluster headaches. Neurology. 1958, 8 (9): 653-663. 10.1212/WNL.8.9.653.CrossRefPubMed
15.
16.
go back to reference Ekbom K: Lithium for cluster headache: review of the literature and preliminary results of long-term treatment. Headache. 1981, 21 (4): 132-139. 10.1111/j.1526-4610.1981.hed2104132.x.CrossRefPubMed Ekbom K: Lithium for cluster headache: review of the literature and preliminary results of long-term treatment. Headache. 1981, 21 (4): 132-139. 10.1111/j.1526-4610.1981.hed2104132.x.CrossRefPubMed
17.
go back to reference Manzoni GC, Bono G, Lanfranchi M, Micieli G, Terzano MG, Nappi G: Lithium carbonate in cluster headache: assessment of its short- and long-term therapeutic efficacy. Cephalalgia. 1983, 3 (2): 109-114. 10.1046/j.1468-2982.1983.0302109.x.CrossRefPubMed Manzoni GC, Bono G, Lanfranchi M, Micieli G, Terzano MG, Nappi G: Lithium carbonate in cluster headache: assessment of its short- and long-term therapeutic efficacy. Cephalalgia. 1983, 3 (2): 109-114. 10.1046/j.1468-2982.1983.0302109.x.CrossRefPubMed
18.
go back to reference Ekbom K: Prophylactic treatment of cluster headache with a new serotonin antagonist, BC 105. Acta Neurol Scand. 1969, 45 (5): 601-610.CrossRefPubMed Ekbom K: Prophylactic treatment of cluster headache with a new serotonin antagonist, BC 105. Acta Neurol Scand. 1969, 45 (5): 601-610.CrossRefPubMed
19.
go back to reference Leone M, D’Amico D, Moschiano F, Fraschini F, Bussone G: Melatonin versus placebo in the prophylaxis of cluster headache: a double-blind pilot study with parallel groups. Cephalalgia. 1996, 16 (7): 494-496. 10.1046/j.1468-2982.1996.1607494.x.CrossRefPubMed Leone M, D’Amico D, Moschiano F, Fraschini F, Bussone G: Melatonin versus placebo in the prophylaxis of cluster headache: a double-blind pilot study with parallel groups. Cephalalgia. 1996, 16 (7): 494-496. 10.1046/j.1468-2982.1996.1607494.x.CrossRefPubMed
20.
go back to reference Gallagher RM, Mueller LL, Freitag FG: Divalproex sodium in the treatment of migraine and cluster headaches. J Am Osteopath Assoc. 2002, 102 (2): 92-94.PubMed Gallagher RM, Mueller LL, Freitag FG: Divalproex sodium in the treatment of migraine and cluster headaches. J Am Osteopath Assoc. 2002, 102 (2): 92-94.PubMed
21.
go back to reference Hering R, Kuritzky A: Sodium valproate in the treatment of cluster headache: an open clinical trial. Cephalalgia. 1989, 9 (3): 195-198.CrossRefPubMed Hering R, Kuritzky A: Sodium valproate in the treatment of cluster headache: an open clinical trial. Cephalalgia. 1989, 9 (3): 195-198.CrossRefPubMed
22.
go back to reference Förderreuther S, Mayer M, Straube A: Treatment of cluster headache with topiramate: effects and side-effects in five patients. Cephalalgia. 2002, 22 (3): 186-189. 10.1046/j.1468-2982.2002.00339.x.CrossRefPubMed Förderreuther S, Mayer M, Straube A: Treatment of cluster headache with topiramate: effects and side-effects in five patients. Cephalalgia. 2002, 22 (3): 186-189. 10.1046/j.1468-2982.2002.00339.x.CrossRefPubMed
23.
go back to reference Láinez MJA, Pascual J, Pascual AM, Santonja JM, Ponz A, Salvador A: Topiramate in the prophylactic treatment of cluster headache. Headache. 2003, 43 (7): 784-789. 10.1046/j.1526-4610.2003.03137.x.CrossRefPubMed Láinez MJA, Pascual J, Pascual AM, Santonja JM, Ponz A, Salvador A: Topiramate in the prophylactic treatment of cluster headache. Headache. 2003, 43 (7): 784-789. 10.1046/j.1526-4610.2003.03137.x.CrossRefPubMed
24.
go back to reference Schuh-Hofer S, Israel H, Neeb L, Reuter U, Arnold G: The use of gabapentin in chronic cluster headache patients refractory to first-line therapy. Eur J Neurol. 2007, 14 (6): 694-696. 10.1111/j.1468-1331.2007.01738.x.CrossRefPubMed Schuh-Hofer S, Israel H, Neeb L, Reuter U, Arnold G: The use of gabapentin in chronic cluster headache patients refractory to first-line therapy. Eur J Neurol. 2007, 14 (6): 694-696. 10.1111/j.1468-1331.2007.01738.x.CrossRefPubMed
25.
go back to reference El Amrani M, Massiou H, Bousser MG: A negative trial of sodium valproate in cluster headache: methodological issues. Cephalalgia. 2002, 22 (3): 205-208. 10.1046/j.1468-2982.2002.00349.x.CrossRefPubMed El Amrani M, Massiou H, Bousser MG: A negative trial of sodium valproate in cluster headache: methodological issues. Cephalalgia. 2002, 22 (3): 205-208. 10.1046/j.1468-2982.2002.00349.x.CrossRefPubMed
26.
go back to reference Pringsheim T, Magnoux E, Dobson CF, Hamel E, Aubé M: Melatonin as adjunctive therapy in the prophylaxis of cluster headache: a pilot study. Headache. 2002, 42 (8): 787-792. 10.1046/j.1526-4610.2002.02181.x.CrossRefPubMed Pringsheim T, Magnoux E, Dobson CF, Hamel E, Aubé M: Melatonin as adjunctive therapy in the prophylaxis of cluster headache: a pilot study. Headache. 2002, 42 (8): 787-792. 10.1046/j.1526-4610.2002.02181.x.CrossRefPubMed
27.
go back to reference Monstad I, Krabbe A, Micieli G, Prusinski A, Cole J, Pilgrim A, Shevlin P: Preemptive oral treatment with sumatriptan during a cluster period. Headache. 1995, 35 (10): 607-613. 10.1111/j.1526-4610.1995.hed3510607.x.CrossRefPubMed Monstad I, Krabbe A, Micieli G, Prusinski A, Cole J, Pilgrim A, Shevlin P: Preemptive oral treatment with sumatriptan during a cluster period. Headache. 1995, 35 (10): 607-613. 10.1111/j.1526-4610.1995.hed3510607.x.CrossRefPubMed
28.
go back to reference Mulder LJ, Spierings EL: Naratriptan in the preventive treatment of cluster headache. Cephalalgia. 2002, 22 (10): 815-817. 10.1046/j.1468-2982.2002.00424.x.CrossRefPubMed Mulder LJ, Spierings EL: Naratriptan in the preventive treatment of cluster headache. Cephalalgia. 2002, 22 (10): 815-817. 10.1046/j.1468-2982.2002.00424.x.CrossRefPubMed
29.
go back to reference Zebenholzer K, Wöber C, Vigl M, Wessely P: Eletriptan for the short-term prophylaxis of cluster headache. Headache. 2004, 44 (4): 361-364. 10.1111/j.1526-4610.2004.04079.x.CrossRefPubMed Zebenholzer K, Wöber C, Vigl M, Wessely P: Eletriptan for the short-term prophylaxis of cluster headache. Headache. 2004, 44 (4): 361-364. 10.1111/j.1526-4610.2004.04079.x.CrossRefPubMed
30.
go back to reference Peres MFP, Stiles MA, Siow HC, Rozen TD, Young WB, Silberstein SD: Greater occipital nerve blockade for cluster headache. Cephalalgia. 2002, 22 (7): 520-522. 10.1046/j.1468-2982.2002.00410.x.CrossRefPubMed Peres MFP, Stiles MA, Siow HC, Rozen TD, Young WB, Silberstein SD: Greater occipital nerve blockade for cluster headache. Cephalalgia. 2002, 22 (7): 520-522. 10.1046/j.1468-2982.2002.00410.x.CrossRefPubMed
31.
go back to reference Busch V, Jakob W, Juergens T, Schulte-Mattler W, Kaube H, May A: Occipital nerve blockade in chronic cluster headache patients and functional connectivity between trigeminal and occipital nerves. Cephalalgia. 2007, 27 (11): 1206-1214. 10.1111/j.1468-2982.2007.01424.x.CrossRefPubMed Busch V, Jakob W, Juergens T, Schulte-Mattler W, Kaube H, May A: Occipital nerve blockade in chronic cluster headache patients and functional connectivity between trigeminal and occipital nerves. Cephalalgia. 2007, 27 (11): 1206-1214. 10.1111/j.1468-2982.2007.01424.x.CrossRefPubMed
32.
go back to reference Ambrosini A, Vandenheede M, Rossi P, Aloj F, Sauli E, Pierelli F, Schoenen J: Suboccipital injection with a mixture of rapid- and long-acting steroids in cluster headache: a double-blind placebo-controlled study. Pain. 2005, 118 (1–2): 92-96.CrossRefPubMed Ambrosini A, Vandenheede M, Rossi P, Aloj F, Sauli E, Pierelli F, Schoenen J: Suboccipital injection with a mixture of rapid- and long-acting steroids in cluster headache: a double-blind placebo-controlled study. Pain. 2005, 118 (1–2): 92-96.CrossRefPubMed
33.
go back to reference Leroux E, Valade D, Taifas I, Vicaut I, Chagnon M, Roos C, Ducros A: Suboccipital steroid injections for transitional treatment of patients with more than 2 cluster headache attacks per day: a randomized, double-blind, placebo-controlled trial. Lancet Neurol. 2011, 10: 881-897. 10.1016/S1474-4422(11)70154-5.CrossRef Leroux E, Valade D, Taifas I, Vicaut I, Chagnon M, Roos C, Ducros A: Suboccipital steroid injections for transitional treatment of patients with more than 2 cluster headache attacks per day: a randomized, double-blind, placebo-controlled trial. Lancet Neurol. 2011, 10: 881-897. 10.1016/S1474-4422(11)70154-5.CrossRef
34.
go back to reference Ware JE, Kosinski M, Keller SD: A 12-item short form health survey. Med Care. 1996, 34: 220-223. 10.1097/00005650-199603000-00003.CrossRefPubMed Ware JE, Kosinski M, Keller SD: A 12-item short form health survey. Med Care. 1996, 34: 220-223. 10.1097/00005650-199603000-00003.CrossRefPubMed
35.
go back to reference Kosinski M, Bayliss MS, Bjorner JB, Ware JE, Garber WH, Batenhorst A, Cady R, Dahlöf CG, Dowson A, Tepper S: A six-item short-form survey for measuring headache impact: the HIT-6. Qual Life Res. 2003, 12: 963-974. 10.1023/A:1026119331193.CrossRefPubMed Kosinski M, Bayliss MS, Bjorner JB, Ware JE, Garber WH, Batenhorst A, Cady R, Dahlöf CG, Dowson A, Tepper S: A six-item short-form survey for measuring headache impact: the HIT-6. Qual Life Res. 2003, 12: 963-974. 10.1023/A:1026119331193.CrossRefPubMed
36.
go back to reference Hautzinger M, Bailer M: Allgemeine Depressions Skala. Manual. 1993, Göttingen: Beltz Test GmbH Hautzinger M, Bailer M: Allgemeine Depressions Skala. Manual. 1993, Göttingen: Beltz Test GmbH
37.
go back to reference Guy W, et al: Clinical Global Impressions (CGI) Scale. Psychiatric Measures. Edited by: Rush J. 2000, Washington DC: APA Guy W, et al: Clinical Global Impressions (CGI) Scale. Psychiatric Measures. Edited by: Rush J. 2000, Washington DC: APA
Metadata
Title
Study protocol of Prednisone in episodic Cluster Headache (PredCH): a randomized, double-blind, placebo-controlled parallel group trial to evaluate the efficacy and safety of oral prednisone as an add-on therapy in the prophylactic treatment of episodic cluster headache with verapamil
Authors
Dagny Holle
Jan Burmeister
André Scherag
Claudia Ose
Hans-Christoph Diener
Mark Obermann
Publication date
01-12-2013
Publisher
BioMed Central
Published in
BMC Neurology / Issue 1/2013
Electronic ISSN: 1471-2377
DOI
https://doi.org/10.1186/1471-2377-13-99

Other articles of this Issue 1/2013

BMC Neurology 1/2013 Go to the issue