Recently available and emerging therapeutic strategies for the acute and prophylactic management of cluster headache: a systematic review and expert opinion

Vikelis, Michail; Mantovani, Elisa; Litsardopoulos, Pantelis; Tamburin, Stefano

doi:10.1080/14737175.2021.1857240

Cited by 9 publications

(5 citation statements)

References 49 publications

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“…Unfortunately, the problems for CH do not end here because only part of these suffering patients can take advantage of a new therapy that has been extended from migraine also to CH in the USA and immediately abates the crises. In fact, on February 28, 2020, the European Medicines Agency (EMA) rejected the approval of galcanezumab (100 mg 9 3/monthly subcutaneously) for the prevention of episodic and chronic cluster headache, a highly effective therapy currently available in USA after the Food Drug and Administration approval [20][21][22][23]. There is hope today for a reassessment by EMA after the publication of ongoing studies on RWE.…”

Section: Old and Novel Treatments For Chmentioning

confidence: 99%

Cluster Headache is Still Lurking in the Shadows

Martelletti

Curto

2021

Pain Ther

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Cluster headache, apart from its legendary reputation as the most violent headache that can exist, suffers from an average 60-month delay in diagnosis. The simplicity of the clinical manifestations, although dramatic, makes this delay inexplicable. The education of emergency department physicians and various specialists not specifically dedicated to headaches allows cluster headache to remain in a lurking position with flourishing periods of disease that are often unpredictable in both onset and disappearance.Older drugs have always shown high efficacy but also an equally high rate of adverse events, often discouraging their appropriate use. The availability of a new drug class such as monoclonal antibodies for calcitonin gene-related peptide or its receptor (CGRP (r) ), which have already been efficient for migraine, shows a jeopardized geography of access in the world, and this favors the progression of the episodic form into chronic and of the chronic into refractory.

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Section: Old and Novel Treatments For Chmentioning

confidence: 99%

Cluster Headache is Still Lurking in the Shadows

Martelletti

Curto

2021

Pain Ther

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“…Therapy management remains a challenge due to significant morbidity if not treated effectively and immediately (Goyal et al, 2024;Mehta et al, 2020;Sharma et al, 2020;Wood et al, 2022). Although several therapeutic approaches have shown success, chronic tensiontype headaches are often difficult to manage (Argyriou et al, 2021;Sait et al, 2021;Shahverdi et al, 2024). Chronic tension-type headache becomes a risk factor for the overuse of analgesic drugs, and only 20% of patients visit a doctor.…”

Section: Introductionmentioning

confidence: 99%

“…Prophylactic pharmacological therapy in conjunction with non-pharmacological therapy should be considered. Non-pharmacological therapy has been reported to have benefits with minor side effects (Argyriou et al, 2021;Dimitriou et al, 2020;Moisset et al, 2020). Brainwave entrainment therapy using binaural beats is a non-medication therapy that can be considered for managing chronic headaches as an alternative or complementary therapy (Vasiliou et al, 2021).…”

Section: Introductionmentioning

confidence: 99%

The Effect of Alpha Binaural Beats Auditory Stimulation on Quantitative Electroencephalography (QEEG) and Pain Intensity among Tension-Type Headache Patients

Asmara,

Wuysang,

Basir

et al. 2024

AJESH

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Tension-type headaches, the most prevalent primary headaches affecting 2-5% of the population, significantly impact sufferers' well-being. These headaches present a persistent health challenge, constituting a considerable portion of neurologist outpatient visits. Effectively managing tension-type headaches remains challenging and can lead to notable morbidity if untreated. Treatment typically involves prophylactic pharmacological therapy alongside non-pharmacological interventions. Among non-medication therapies, brainwave entrainment using binaural beats emerges as a promising option for chronic headaches. This experimental research employed a pre-test and post-test design over a 5-day period (30 minutes daily) to assess Alpha Binaural Beats Auditory stimulation's impact on the QEEG pattern and pain intensity reduction in tension-type headache patients. The study, involving 32 participants, revealed a statistically significant increase in relative alpha wave power (p-value of 0.000) and a significant decrease in relative beta wave power (p-value of 0.045) after exposure to alpha binaural beats. Additionally, the Numerical Rating Scale (NRS) recorded a statistically significant decrease in pain intensity (p-value of 0.000). These findings suggest that Alpha binaural beats contribute to increased alpha wave activity, decreased beta wave activity in the QEEG pattern, and a substantial reduction in pain intensity associated with tension-type headaches. However, further research is needed to explore cumulative effects and long-term sustainability in tension-type headache patients, advancing our understanding and application of this therapy.

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“…Other drugs commonly taken are the dihydroergotamine nasal sprays or injections or neuroleptics, non-steroidal anti-inflammatory drugs and corticosteroids. However, the treatments usually are slight effi- cient and limited by side-effects, as unintentional abuse [8]. On the other hand, although more than 40 drug therapies are used to prevent migraine, by now, only five agents are approved by the US Food and Drug Administration (FDA) for the prevention of EM: the beta-adrenergic blocking agents, propranolol and timolol, and the anticonvulsants divalproex sodium or sodium valproate and topiramate [9].…”

Section: Introductionmentioning

confidence: 99%

Chronic Migraine: A Narrative Review on the Use of Botulinum Toxin with Clinical Indications and Future Directions

Raciti¹,

Raciti²,

Militi³

et al. 2022

J. Integr. Neurosci.

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Chronic migraine belongs to the "chronic long-duration headaches", and it is associated to high burden and significant economic impact. Treatment for both episodic (EM) and chronic migraine (CM) is based on the management of acute attacks and their prevention. For moderate/severe attacks, pharmacological therapies are triptans, dihydroergotamine nasal sprays or injections or neuroleptics, non-steroidal anti-inflammatory drugs, and corticosteroids. Chronic migraine belongs to the "chronic long-duration headaches", and it is associated to high burden and significant economic impact. Treatment for both episodic (EM) and chronic migraine (CM) is based on the management of acute attacks and their prevention. For moderate/severe attacks, pharmacological therapies are triptans, dihydroergotamine nasal sprays or injections or neuroleptics, non-steroidal anti-inflammatory drugs, and corticosteroids. The pathophysiology of CM is characterized by an abnormal activation of the trigemino-vascular system in the meninges causing a neurogenic inflammation, which explains the use of anti-inflammatory during attacks. It seems that the objective of the preventive therapy with the botulin toxin OnaBoNT-A consists in interrupting the release of CGRP and other neuropeptides as well as the activation of C-fiber nociceptor and of the nearby A-delta fibers. The protocol for migraine treatment with OnaBoNT-A injections consists of 31-39 pericranial injection sites involving seven muscle groups bilaterally in specific areas of the head and neck, with a total dose of between 155 and 195 units, every three months. The severe adverse events reported with high doses of botulin toxin for spasticity, have not been reported for CM treated with OnabotA at the labeled dose. The established improvement with onabotulinumtoxinA treatment in CM patients had a positive impact not only in reduction monthly headache days but also in improving quality of life, with reduction in both healthcare resource utilisation (HRU) and work impairment. Aim of this review was to give an overview on the use of BoNT-A in patients with CM, giving practical advices on the clinical indications.

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Recently available and emerging therapeutic strategies for the acute and prophylactic management of cluster headache: a systematic review and expert opinion

Cited by 9 publications

References 49 publications

Cluster Headache is Still Lurking in the Shadows

Cluster Headache is Still Lurking in the Shadows

The Effect of Alpha Binaural Beats Auditory Stimulation on Quantitative Electroencephalography (QEEG) and Pain Intensity among Tension-Type Headache Patients

Chronic Migraine: A Narrative Review on the Use of Botulinum Toxin with Clinical Indications and Future Directions

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