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Predictors of Acute Treatment Response Among Patients With Cluster Headache

CME

Authors

  • Markus Schürks MD,

  • Dieter Rosskopf MD,

  • Janete De Jesus MD,

  • Mira Jonjic MD,

  • Hans-Christoph Diener MD,

  • Tobias Kurth MD, ScD


  • From the Department of Neurology, University of Duisburg-Essen, Essen, Germany (Drs. Schürks, de Jesus, Jonjic, and Diener); Institute of Pharmacology, Research Center of Pharmacology and Experimental Therapeutics, University Hospital, Ernst-Moritz Arndt University, Greifswald, Germany (Dr. Rosskopf); Divisions of Preventive Medicine and Aging, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, and Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA (Dr. Kurth)

Address all correspondence to Dr. Markus Schürks, Department of Neurology, University Hospital Essen. Hufelandstrasse 55, 45122 Essen, Germany.

Abstract

Background.—Oxygen and triptans are drugs of first choice to abort cluster headache attacks. However, clinical predictors of treatment response are unavailable.

Objective.—We aimed to identify predictors of acute treatment response among patients with cluster headache.

Methods.—We investigated 246 cluster headache patients with available information on personal, headache, and lifestyle characteristics as well as effectiveness of acute medication use. We used logistic regression models to identify potential predictors of triptan and oxygen response.

Results.—Triptans were effective in 137 of the 191 users and oxygen in 134 of the 175 users. We only identified increasing age (OR 0.96, 95% CI 0.93–0.99; P= .013) as a negative predictor for triptan response, while nausea/vomiting (OR 0.41, 95% CI 0.18–0.91; P= .029) and restlessness (OR 0.09, 95% CI 0.01–0.66; P= .019) were negative predictors of oxygen response.

Conclusions.—Few clinical features seem to predict treatment nonresponse in cluster headache. More refined studies aiming at physiological and genetic characteristics seem promising in the future.

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