Randomised trial on episodic cluster headache with an angiotensin II receptor blocker

Tronvik, Erling; Wienecke, Troels; Monstad, Iril; Dahlöf, Carl; Bøe, Magne Geir; Tjensvoll, Anne Bolette; Salvesen, Rolf; Zwart, John Anker; Jansson, Sven-Olof; Stovner, Lars Jacob

doi:10.1177/0333102413484989

Cited by 13 publications

(38 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A Class II parallel group study evaluated candesartan 16 mg daily for 1 week followed by 32 mg daily for 2 weeks in episodic CH prophylaxis with 32 patients completing the study. The study failed to meet the primary endpoint, with a mean reduction in attacks per week from week 1 to week 3 of 8.7 ± 9.12 for candesartan vs 6.2 ± 8.71 for placebo (61% vs 38% attack reduction, P = .38).…”

Section: Resultsmentioning

confidence: 99%

Treatment of Cluster Headache: The American Headache Society Evidence‐Based Guidelines

et al. 2016

View full text Add to dashboard Cite

Background.-Cluster headache (CH), the most common trigeminal autonomic cephalalgia, is an extremely debilitating primary headache disorder that is often not optimally treated. New evidence-based treatment guidelines for CH will assist clinicians with identifying and choosing among current treatment options.Objectives.-In this systematic review we appraise the available evidence for the acute and prophylactic treatment of CH, and provide an update of the 2010 American Academy of Neurology (AAN) endorsed systematic review.Methods.-Medline, PubMed, and EMBASE databases were searched for double-blind, randomized controlled trials that investigated treatments of CH in adults. Exclusion and inclusion criteria were identical to those utilized in the 2010 AAN systematic review.Results and Recommendations.-For acute treatment, sumatriptan subcutaneous, zolmitriptan nasal spray, and high flow oxygen remain the treatments with a Level A recommendation. Since the 2010 review, a study of sphenopalatine ganglion stimulation was added to the current guideline and has been administered a Level B recommendation for acute treatment. For prophylactic therapy, previously there were no treatments that were administered a Level A recommendation. For the current guidelines, suboccipital steroid injections have emerged as the only treatment to receive a Level A recommendation with the addition of a second Class I study. Other newly evaluated treatments since the 2010 guidelines have been given a Level B recommendation (negative study: deep brain stimulation), a Level C recommendation (positive study: warfarin; negative studies: cimetidine/chlorpheniramine, candesartan), or a Level U recommendation (frovatriptan).Conclusions.-This AHS guideline can be utilized for understanding which therapies have superiority to placebo or sham treatment in the management of CH. In clinical practice, these recommendations should be considered in concert with other variables including safety, side effects, patient preferences, clinician experience, cost, and the invasiveness of the intervention. Given the lack of Class I evidence and Level A recommendations, particularly for a number of commonly used preventive therapies, further studies are warranted to demonstrate safety and efficacy for established and emerging therapies.

show abstract

Section: Resultsmentioning

confidence: 99%

Treatment of Cluster Headache: The American Headache Society Evidence‐Based Guidelines

et al. 2016

View full text Add to dashboard Cite

show abstract

“…One may speculate that a higher dose could result in more responders. The choice of dose of CAN (16 mg per day) in this study was based on the previous migraine study that showed effect and excellent tolerability (6), but a dose of 32 mg has been tried with good tolerability in cluster headache (19). A dose-finding study in adults with migraine seems warranted.…”

Section: Discussionmentioning

confidence: 99%

A comparative study of candesartan versus propranolol for migraine prophylaxis: A randomised, triple-blind, placebo-controlled, double cross-over study

et al. 2013

Self Cite

View full text Add to dashboard Cite

show abstract

“…Of the included studies, nine [19][20][21]26,27,31,32,34,37] were crossover designs, and fourteen [22][23][24][25][28][29][30]33,35,36,[38][39][40][41] were parallel studies. Regarding the types of therapy involved, seven trials [20,21,23,27,31,34,35] investigated triptans to treat CH, and sixteen [19,22,[24][25][26][28][29][30]32,33,[36][37][38][39][40][41] investigated non-triptans. The therapy type consisted of thirteen preventive [19,23,24,[28]…”

Section: Study Descriptionmentioning

confidence: 99%

Comparative Impact of Pharmacological Therapies on Cluster Headache Management: A Systematic Review and Network Meta-Analysis

Kwon

Han

Choi

et al. 2022

JCM

View full text Add to dashboard Cite

It is important to find effective and safe pharmacological options for managing cluster headache (CH) because there is limited evidence from studies supporting the general efficacy and safety of pharmacological therapies. This systematic review and network meta-analysis (NMA) analyzed published randomized controlled trials (RCTs) to evaluate the efficacy and safety of pharmacological treatments in patients with CH. The PubMed and Embase databases were searched to identify RCTs that evaluated the efficacy and safety of pharmacological treatments for CH. Efficacy outcomes included frequency and duration of attacks, pain-free rate, and the use of rescue agents. Safety outcomes were evaluated based on the number of patients who experienced adverse events. A total of 23 studies were included in the analysis. The frequency of attacks was reduced (mean difference (MD) = −1.05, 95% confidence interval (CI) = −1.62 to −0.47; p = 0.0004), and the pain-free rate was increased (odds ratio (OR) = 3.89, 95% CI = 2.76–5.48; p < 0.00001) in the pharmacological treatment group, with a lower frequency of rescue agent use than the placebo group. Preventive, acute, and triptan or non-triptan therapies did not show significant differences in efficacy (p > 0.05). In the NMA, different results were shown among the interventions; for example, zolmitriptan 5 mg was more effective than zolmitriptan 10 mg in the pain-free outcome (OR = 0.40, 95% CI = 0.19–0.82; p < 0.05). Pharmacological treatment was shown to be more effective than placebo to manage CH with differences among types of therapies and individual interventions, and it was consistently shown to be associated with the development of adverse events. Thus, individualized therapy approaches should be applied to treat CH in real-world practice.

show abstract

Randomised trial on episodic cluster headache with an angiotensin II receptor blocker

Abstract: This was a negative trial. Post-hoc statistics suitable to describe the temporal changes in cluster headache indicate that conduction of future larger studies may be justified.

Cited by 13 publications

References 22 publications

Treatment of Cluster Headache: The American Headache Society Evidence‐Based Guidelines

Treatment of Cluster Headache: The American Headache Society Evidence‐Based Guidelines

A comparative study of candesartan versus propranolol for migraine prophylaxis: A randomised, triple-blind, placebo-controlled, double cross-over study

Comparative Impact of Pharmacological Therapies on Cluster Headache Management: A Systematic Review and Network Meta-Analysis

Contact Info

Product

Resources

About