Complete withdrawal is the most effective approach to reduce disability in patients with medication-overuse headache: A randomized controlled open-label trial
Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
Standard
Complete withdrawal is the most effective approach to reduce disability in patients with medication-overuse headache : A randomized controlled open-label trial. / Nielsen, Mia; Carlsen, Louise Ninett; Munksgaard, Signe Bruun; Engelstoft, Ida Maria Storm; Jensen, Rigmor Højland; Bendtsen, Lars.
I: Cephalalgia, Bind 39, Nr. 7, 2019, s. 863-872.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
Harvard
APA
Vancouver
Author
Bibtex
}
RIS
TY - JOUR
T1 - Complete withdrawal is the most effective approach to reduce disability in patients with medication-overuse headache
T2 - A randomized controlled open-label trial
AU - Nielsen, Mia
AU - Carlsen, Louise Ninett
AU - Munksgaard, Signe Bruun
AU - Engelstoft, Ida Maria Storm
AU - Jensen, Rigmor Højland
AU - Bendtsen, Lars
PY - 2019
Y1 - 2019
N2 - Background: Medication-overuse headache leads to high disability and decreased quality of life, and the best approach for withdrawal has been debated. Aim: To compare change in disability and quality of life between two withdrawal programs. Methods: We randomized medication-overuse headache patients to program A (two months without acute analgesics or migraine medications) or program B (two months with acute medications restricted to two days/week) in a prospective, outpatient study. At 6 and 12 months, we measured disability and headache burden by the Headache Under-Response to Treatment index (HURT). We estimated quality of life by EUROHIS-QOL 8-item at 2-, 6-, and 12-month follow-up. Primary endpoint was disability change at 12 months. Results: We included 72 medication-overuse headache patients with primary migraine and/or tension-type headache. Fifty nine completed withdrawal and 54 completed 12-month follow-up. At 12-month follow-up, 41 patients completed HURT and 38 completed EUROHIS-QOL 8-item. Disability reduction was 25% in program-A and 7% in program-B (p = 0.027). Headache-burden reduction was 33% in program-A and 3% in program-B (p = 0.005). Quality of life was increased by 8% in both programs without significant difference between the programs (p = 0.30). At 2-month follow-up, quality of life increased significantly more in program-A than program-B (p = 0.006). Conclusion: Both withdrawal programs reduced disability and increased quality of life. Withdrawal without acute medication was the most effective in reducing disability in medication-overuse headache patients. Trial registration: Clinicaltrials.gov (NCT02903329).
AB - Background: Medication-overuse headache leads to high disability and decreased quality of life, and the best approach for withdrawal has been debated. Aim: To compare change in disability and quality of life between two withdrawal programs. Methods: We randomized medication-overuse headache patients to program A (two months without acute analgesics or migraine medications) or program B (two months with acute medications restricted to two days/week) in a prospective, outpatient study. At 6 and 12 months, we measured disability and headache burden by the Headache Under-Response to Treatment index (HURT). We estimated quality of life by EUROHIS-QOL 8-item at 2-, 6-, and 12-month follow-up. Primary endpoint was disability change at 12 months. Results: We included 72 medication-overuse headache patients with primary migraine and/or tension-type headache. Fifty nine completed withdrawal and 54 completed 12-month follow-up. At 12-month follow-up, 41 patients completed HURT and 38 completed EUROHIS-QOL 8-item. Disability reduction was 25% in program-A and 7% in program-B (p = 0.027). Headache-burden reduction was 33% in program-A and 3% in program-B (p = 0.005). Quality of life was increased by 8% in both programs without significant difference between the programs (p = 0.30). At 2-month follow-up, quality of life increased significantly more in program-A than program-B (p = 0.006). Conclusion: Both withdrawal programs reduced disability and increased quality of life. Withdrawal without acute medication was the most effective in reducing disability in medication-overuse headache patients. Trial registration: Clinicaltrials.gov (NCT02903329).
KW - detoxification
KW - disability
KW - Medication-overuse
KW - quality of life
KW - restricted medication-intake
U2 - 10.1177/0333102419828994
DO - 10.1177/0333102419828994
M3 - Journal article
C2 - 30732459
AN - SCOPUS:85061661775
VL - 39
SP - 863
EP - 872
JO - Cephalalgia
JF - Cephalalgia
SN - 0800-1952
IS - 7
ER -
ID: 235785004