Effect of calcitonin gene-related peptide (-receptor) antibodies in chronic cluster headache: Results from a retrospective case series support individual treatment attempts

Ruscheweyh, Ruth; Broessner, Gregor; Goßrau, Gudrun; Heinze‐Kuhn, Katja; Jürgens, Tim P.; Kaltseis, Katharina; Kamm, Katharina; Peikert, Andreas; Raffaelli, Bianca; Rimmele, Florian; Evers, Stefan

doi:10.1177/0333102420949866

Cited by 32 publications

(25 citation statements)

References 33 publications

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“…Given the negative trial results of anti‐CGRP monoclonal antibodies in chronic cluster, perhaps chronic CH is only associated with CGRP pathology in some patients. There are some data to support this, 86,87 and to suggest some may benefit there is a case series 88 …”

Section: Discussionmentioning

confidence: 91%

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Effects of acute and preventive therapies for episodic and chronic cluster headache: A scoping review of the literature

et al. 2022

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Background: Cluster headache is the most common primary headache disorder of the trigeminal autonomic cephalalgias, and it is highly disabling.Objective: We undertake a scoping review to characterize therapies to prevent and acutely treat cluster headache, characterize trial methodology utilized in studies, and recommend future trial "good practices." We also assess homogeneity of studies and feasibility for future network meta-analyses (NMAs) to compare acute and preventive treatments for cluster headache. Methods:A priori protocol for this scoping review was registered and available on Open Science Forum. We sought studies that enrolled adult patients with cluster headache as identified by accepted diagnostic criteria. Both randomized controlled trials (RCTs) and observational studies (with a control group) were included. The interventions of interest were medications, procedures, devices, surgeries, and behavioral/psychological interventions, whereas comparators of interest were placebo, sham, or other active treatments.Outcomes were predefined; however, we did not exclude studies lacking these outcomes.A systemic search was conducted in Ovid Medline, Embase, and Cochrane. We performed a targeted search for conference abstracts from journals prominent in the field. Results:We identified 56 studies: 45 RCTs, four studies only available in clinical trial registries, and seven observational studies. Of the 45 RCTs, 20 focused on acute therapies and 25 on preventive therapies. Overall, we determined that it is feasible to pursue a NMA for acute therapy focusing on 15 or 30-min headache reduction for acute trials, as we identified 11 trials in the combined population of patients with either episodic or chronic cluster headache (2 trials in populations with chronic cluster headache were also found). For preventive therapy of cluster headache, we identified trials with common outcomes that may be considered for NMA, however, as these trials had differences in treatment effect modifiers that could not be corrected, NMAs appear infeasible for this indication. We identified new studies looking at noninvasive vagal nerve stimulation, sphenopalatine ganglion stimulation, prednisone, and oxygen published since the most recent systematic review in the field, although these acute treatments were previously identified as effective. However, for calcitonin gene-related Rationale for this workThere are few evidence-based treatments available in CH, 3,4 as it is a condition that has been under studied. 1 The current scoping review was designed to expand upon past reviews in several ways. First, we sought to identify new studies published since the prior reviews were completed. 3,4 Second, with the data gathered in this scoping review, we aimed to assess the feasibility of pursuing network metaanalyses (NMAs) 5,6 to inform comparisons of multiple treatments based on available direct and indirect evidence in the field. We planned to systematically evaluate study and population features to establish the potential for rigorous N...

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Section: Discussionmentioning

confidence: 91%

“…There are some data to support this, 86,87 and to suggest some may benefit there is a case series. 88…”

Section: Ta B L E 5 Summary Of Findings and Interventions Used As Pre...mentioning

confidence: 99%

Effects of acute and preventive therapies for episodic and chronic cluster headache: A scoping review of the literature

et al. 2022

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“…Importantly, the dose for cluster headache is 300 mg monthly, whereas the dose for migraine is only 120 mg. Galcanezumab was not as effective in a separate trial for chronic cluster headache 161. However, given the refractory nature of chronic cluster headache in many patients, some authors advocate its use in chronic cluster headache given its effectiveness in isolated cases 162…”

Section: Treatmentmentioning

confidence: 99%

“…161 However, given the refractory nature of chronic cluster headache in many patients, some authors advocate its use in chronic cluster headache given its effectiveness in isolated cases. 162…”

Section: Galcanezumabmentioning

confidence: 99%

Recent advances in the diagnosis and management of cluster headache

Schindler

Burish

2022

BMJ

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Cluster headache, a primary headache disorder, consists of short (15-180 minutes), frequent (up to eight a day), unilateral attacks of facial pain with associated ipsilateral autonomic features and restlessness. The attacks are suspected to be one of the most painful human experiences, and the disorder is associated with a high rate of suicidal ideation. Proper diagnosis is key, as some of the most effective treatments, such as high flow oxygen gas, are rarely used in other headache disorders. Yet diagnostic delay is typically years for this disorder, as it is often confused with migraine and trigeminal neuralgia, and secondary causes may be overlooked. This review covers the clinical, pathophysiologic, and therapeutic features of cluster headache. Recent updates in diagnosis include the redefinition of chronic cluster headache (remission periods lasting less than three months instead of the previous one month), and recent advances in management include new treatments for episodic cluster headache (galcanezumab and non-invasive vagus nerve stimulation).

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“…In den USA ist Galcanezumab für den episodischen Clusterkopfschmerz zugelassen, die EMA hat dagegen keine Zulassung erteilt. In Einzelfällen kann der Einsatz eines CGRP-Antikörpers aber durchaus eine Option für schwer betroffene, therapierefraktäre Clusterkopfschmerzpatienten sein [35].…”

Section: Einsatz Bei Anderen Kopf-und Gesichtsschmerzerkrankungenunclassified

Neues in der Migränetherapie

Ruscheweyh

Hoffmann

2021

Nervenheilkunde

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ZUSAMMENFASSUNGMigränepatienten brauchen eine wirksame Akuttherapie und in schwereren Fällen auch eine medikamentöse Prophylaxe. In den letzten Jahren sind erstmals gezielt in die Pathophysiologie der Migräne eingreifende Substanzen entwickelt worden, die über die Blockade von CGRP wirken. Dies sind einerseits die Antikörper gegen CGRP und den CGRP-Rezeptor, die prophylaktisch wirken, andererseits die Gepante (CGRP-Rezeptorantagonisten), die sowohl in der Akuttherapie als auch in der Prophylaxe der Migräne eingesetzt werden können. Gemeinsam ist diesen Substanzen ihre gute Verträglichkeit. CGRP-(Rezeptor)-Antikörper haben gegenüber klassischen Prophylaktika den Vorteil eines schnellen Wirkeintritts. Für die Gepante in der Akuttherapie weisen tierexperimentelle Daten darauf hin, dass sie anders als Triptane eventuell nicht zu einem Kopfschmerz bei Medikamentenübergebrauch führen.

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Effect of calcitonin gene-related peptide (-receptor) antibodies in chronic cluster headache: Results from a retrospective case series support individual treatment attempts

Cited by 32 publications

References 33 publications

Effects of acute and preventive therapies for episodic and chronic cluster headache: A scoping review of the literature

Effects of acute and preventive therapies for episodic and chronic cluster headache: A scoping review of the literature

Recent advances in the diagnosis and management of cluster headache

Neues in der Migränetherapie

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