Clinical and Demographical Characteristics of Patients with Medication Overuse Headache in Argentina and Chile: Analysis of the Latin American Section of COMOESTAS Project

Abstract

BackgroundData on the characteristics of Medication Overuse Headache (MOH) in Latin American (LA) are scarce. Here we report the demographic and clinical features of the MOH patients from Argentina and Chile enrolled in the multinational COMOESTAS project in the period 2008–2010.MethodsThe LA population was formed by 240 MOH subjects, 110 from Chile and 130 from Argentina, consecutively attending the local headache centres. In each centre, specifically trained neurologist interviewed and confirmed the diagnosis according to the ICHD-II criteria. A detailed history was collected on an electronic patient record form.ResultsThe mean patient age was 38.6 years, with a female/male ratio of 8:2. The mean time since onset of the primary headache was 21 years, whereas duration of MOH was 3.9 years. The primary headache was migraine without aura in 77.5 % and migraine with aura in 18.8 %. Forty two % of the patients self-reported emotional stress associated with the chronification of headache; 43.8 % reported insomnia. The most overused medications were acute drug combinations containing ergotamine (70 %), NSAIDs (33.8 %) and triptans (5.4 %).ConclusionThough little described, MOH is present also in LA, where it affects mostly women, in the most active decades of life. Some differences emerge as regards the demographic and clinical characteristics of MOH in this population as compared to Europe or Northern America. What seems more worrying about MOH in Argentina and Chile is that most patients overuse ergotamine, a drug that may cause serious adverse events when used chronically. These findings once more underscore the importance of properly diagnose and treat MOH.

Medication overuse headache in Europe and Latin America: general demographic and clinical characteristics, referral pathways and national distribution of painkillers in a descriptive, multinational, multicenter study

“…A better characterization of this population may assist and direct prevention campaigns and relevant therapy of MOH. Recently, a paper of the COMOESTAS project concerning clinical and demographical characteristics of LA patients with MOH has been published [ 12 ].…”

Frecuencia y características de la automedicación en pacientes con cefalea en atención primaria en Lambayeque, Perú

“…La mayoría de pacientes fueron mujeres, hallazgo similar a dos estudios Latinoamericanos realizados en Brasil y Colombia (16,17); es sabido que las mujeres con mayor frecuencia se preocupen más por su salud y acudan más a consulta (18,19) y además con mayor frecuencia tienen cefalea (20).…”

“…Todas estas entidades coexisten, originan o pueden ser el resultado de la presencia de cefalea. Se reportan cifras tan altas como: 26,3%, 20,8% y 43,8% (20).…”

Chronic Daily Headache and Medication Overuse Headache in First-Visit Headache Patients in Korea: A Multicenter Clinic-Based Study

“… 34 35 36 37 38 The proportion of patients with triptan overuse in the present study was 6%, and the proportions of patients with overuse of other medications were similar to those found in previous studies. 13 39 …”

“…New diagnostic criteria for CM and MOH were recently published in the third edition beta version of the International Classification of Headache Disorder (ICHD-3β). 12 Most previous studies of MOH or CDH have applied the previous version or ICHD-3β retrospectively, 10 12 13 and so the frequency of CDH and MOH still needs to be evaluated in a clinic-based setting according to ICHD-3β. The early detection and accurate diagnosis of CM and MOH in CDH patients in neurology clinics is important because only 20–36% of them are reportedly correctly diagnosed by a physician or specialist.…”