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

Terlizzi, Rossana; Munksgaard, Signe Bruun; Bendtsen, Lars; Tassorelli, Cristina; Nappi, Giuseppe; Katsarava, Zaza; Láinez, Miguel J. A.; Goicochea, María Teresa; Shand, Beatriz; Fadić, Ricardo; Spadafora, Santiago; Pagani, Marco; Jensen, Rigmor

doi:10.1186/s10194-016-0612-2

Cited by 39 publications

(52 citation statements)

References 27 publications

(37 reference statements)

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“…20 Primary Headache History.-As expected, migraine as primary headache diagnosis was more frequent among patients overusing migraine-specific symptomatic medications (T-MOH and E-MOH subgroups), while overuse was evenly distributed among A, M, and C for the subjects who both migraine and tension-type as primary headaches. Our findings are reinforced by a review that reports a high prevalence of E-overuse in LA, and a relatively high prevalence of T-overuse in Europe.…”

Section: Discussionmentioning

confidence: 53%

“…Our findings are reinforced by a review that reports a high prevalence of E-overuse in LA, and a relatively high prevalence of T-overuse in Europe. 20 Primary Headache History.-As expected, migraine as primary headache diagnosis was more frequent among patients overusing migraine-specific symptomatic medications (T-MOH and E-MOH subgroups), while overuse was evenly distributed among A, M, and C for the subjects who both migraine and tension-type as primary headaches. Interestingly, the duration of episodic headache before chronification was longer in patients overusing E or T, when compared to patients overusing A and M. The duration of chronic headache and the duration of overuse was instead similar among groups.…”

Section: Discussionmentioning

confidence: 53%

“…We also evaluated migrainerelated disability using the MIDAS questionnaire that rates disability into 4 grades: minimal (0-5), mild (6-10), moderate (11)(12)(13)(14)(15)(16)(17)(18)(19)(20), or severe (>21). We also evaluated migrainerelated disability using the MIDAS questionnaire that rates disability into 4 grades: minimal (0-5), mild (6-10), moderate (11)(12)(13)(14)(15)(16)(17)(18)(19)(20), or severe (>21).…”

Section: Methodsmentioning

confidence: 99%

“…Baseline clinical characteristics were collected using extensive questionnaires supplemented with structured patient interviews. We also evaluated migrainerelated disability using the MIDAS questionnaire that rates disability into 4 grades: minimal (0-5), mild (6-10), moderate (11)(12)(13)(14)(15)(16)(17)(18)(19)(20), or severe (>21). 18 The Hospital Anxiety and Depression Scale (HADS) 19 was used to screen for the presence of depression (HADS subscore for depression ≥8) and anxiety (HADS subscore for anxiety ≥8).…”

Section: Methodsmentioning

confidence: 99%

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Clinical Subtypes of Medication Overuse Headache – Findings From a Large Cohort

Viana

Icco

Allena³

et al. 2019

Headache

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Background.-The International Classification of Headache Disorders lists different subtypes of medication overuse headache (MOH), according to the medication overused. The aim of this study is to evaluate whether the different subtypes correspond to clinically distinguishable phenotypes in a large population.Method.-This descriptive cross-sectional observational study included 660 patients with MOH referred to headache centers in Europe and Latin America as a part of the COMOESTAS project. Information about clinical features was collected with structured patient interviews and with self-administered questionnaires for measuring disability, anxiety, and depression.Results.-Female/male ratio, body mass index, marital status, and level of education were similar among in subjects enrolled in the 5 centers. The mean age was higher among subjects overusing triptans (T-MOH) with respect to subjects overusing simple analgesic (A-MOH). Duration of headache before chronification was longer in T-MOH (19.2 ± 11.9 years) and in subjects overusing ergotamines (E-MOH, 17.8 ± 11.7 years) with respect to the A-MOH group (13.1 ± 10.9; P < .001 and P = .017, respectively) and in T-MOH with respect multiple drug classes (M-MOH, 14.9 ± 11.7; P = .030). Migraine Disability Assessment (MIDAS) score was significantly lower in E-MOH group (33.6 ± 41.6), while T-MOH group (56.8 ± 40.6) had a significant lower MIDAS score with respect to M-MOH (67.2 ± 62.5; P = .016 and P = .037, respectively). Prevalence of depression and anxiety was lower in patients overusing T with respect to other groups of patients (χ 2 = 10.953, P = .027 and χ 2 = 25.725, P < .001, respectively).Conclusion.-In this study on a large and very well characterized population of MOH, we describe the distinctive clinical characteristics of MOH subtypes. These findings contribute to more clearly define the clinical picture of a poorly delineated headache disorder. They also provide some insights in the possible trajectories leading to this highly disabling chronic headache, that is classified as a secondary form, but whose occurrence is entirely dependent on an underlying primary headache. Abbreviations: A simple analgesic, C combination-analgesic, COMOESTAS continuous monitoring of medication overuse headache in Europe and Latin America, E ergotamine, M multiple drug classes not individually overused, MOH medication overuse headache, O opioid, T triptan(

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Section: Discussionmentioning

confidence: 53%

Section: Discussionmentioning

confidence: 53%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Clinical Subtypes of Medication Overuse Headache – Findings From a Large Cohort

Viana

Icco

Allena³

et al. 2019

Headache

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“…Further surveillance studies are required, particularly to monitor the trends of these two drugs in France. The widespread consumption of analgesics raises the concern of overuse , as well as addiction and misuse (approximately 10% and 25% of opioids users, respectively) . Therefore, consideration of therapeutic indications may be useful for monitoring user profiles and trends of misuse, and to carry out appropriate preventive measures (e.g.…”

Section: Discussionmentioning

confidence: 99%