Current treatment options for cluster headache: limitations and the unmet need for better and specific treatments—a consensus article
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Current treatment options for cluster headache : limitations and the unmet need for better and specific treatments—a consensus article. / Lund, Nunu Laura Timotheussen; Petersen, Anja Sofie; Fronczek, Rolf; Tfelt-Hansen, Jacob; Belin, Andrea Carmine; Meisingset, Tore; Tronvik, Erling; Steinberg, Anna; Gaul, Charly; Jensen, Rigmor Højland.
I: Journal of Headache and Pain, Bind 24, Nr. 1, 121, 2023.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Current treatment options for cluster headache
T2 - limitations and the unmet need for better and specific treatments—a consensus article
AU - Lund, Nunu Laura Timotheussen
AU - Petersen, Anja Sofie
AU - Fronczek, Rolf
AU - Tfelt-Hansen, Jacob
AU - Belin, Andrea Carmine
AU - Meisingset, Tore
AU - Tronvik, Erling
AU - Steinberg, Anna
AU - Gaul, Charly
AU - Jensen, Rigmor Højland
N1 - Publisher Copyright: © 2023, Springer-Verlag Italia S.r.l., part of Springer Nature.
PY - 2023
Y1 - 2023
N2 - Aim: Treatment for cluster headache is currently based on a trial-and-error approach. The available preventive treatment is unspecific and based on few and small studies not adhering to modern standards. Therefore, the authors collaborated to discuss acute and preventive treatment in cluster headache, addressing the unmet need of safe and tolerable preventive medication from the perspectives of people with cluster headache and society, headache specialist and cardiologist. Findings: The impact of cluster headache on personal life is substantial. Mean annual direct and indirect costs of cluster headache are more than 11,000 Euros per patient. For acute treatment, the main problems are treatment response, availability, costs and, for triptans, contraindications and the maximum use allowed. Intermediate treatment with steroids and greater occipital nerve blocks are effective but cannot be used continuously. Preventive treatment is sparsely studied and overall limited by relatively low efficacy and side effects. Neurostimulation is a relevant option for treatment-refractory chronic patients. From a cardiologist’s perspective use of verapamil and triptans may be worrisome and regular follow-up is essential when using verapamil and lithium. Conclusion: We find that there is a great and unmet need to pursue novel and targeted preventive modalities to suppress the horrific pain attacks for people with cluster headache. Graphical Abstract: [Figure not available: see fulltext.].
AB - Aim: Treatment for cluster headache is currently based on a trial-and-error approach. The available preventive treatment is unspecific and based on few and small studies not adhering to modern standards. Therefore, the authors collaborated to discuss acute and preventive treatment in cluster headache, addressing the unmet need of safe and tolerable preventive medication from the perspectives of people with cluster headache and society, headache specialist and cardiologist. Findings: The impact of cluster headache on personal life is substantial. Mean annual direct and indirect costs of cluster headache are more than 11,000 Euros per patient. For acute treatment, the main problems are treatment response, availability, costs and, for triptans, contraindications and the maximum use allowed. Intermediate treatment with steroids and greater occipital nerve blocks are effective but cannot be used continuously. Preventive treatment is sparsely studied and overall limited by relatively low efficacy and side effects. Neurostimulation is a relevant option for treatment-refractory chronic patients. From a cardiologist’s perspective use of verapamil and triptans may be worrisome and regular follow-up is essential when using verapamil and lithium. Conclusion: We find that there is a great and unmet need to pursue novel and targeted preventive modalities to suppress the horrific pain attacks for people with cluster headache. Graphical Abstract: [Figure not available: see fulltext.].
KW - Burden
KW - CGRP
KW - Cluster headache
KW - Review
KW - Treatment
KW - Verapamil
U2 - 10.1186/s10194-023-01660-8
DO - 10.1186/s10194-023-01660-8
M3 - Journal article
C2 - 37667192
AN - SCOPUS:85169692458
VL - 24
JO - Journal of Headache and Pain
JF - Journal of Headache and Pain
SN - 1129-2369
IS - 1
M1 - 121
ER -
ID: 366988949