Anaé Monta1, Sylvain Redon2, Cyprien Fabre3, Anne Donnet1,4. 1. Department of Evaluation and Treatment of Pain, FHU INOVPAIN, la Timone Hospital, CHU Timone, AP-HM, Marseille, France. 2. Department of Evaluation and Treatment of Pain, FHU INOVPAIN, la Timone Hospital, CHU Timone, AP-HM, Marseille, France. sylvain.redon@ap-hm.fr. 3. EA 3279, Public Health, Chronic Diseases and Quality of Life, Research Unit, Aix-Marseille University, Marseille, France. 4. INSERM U-1107, CHU de Clermont-Ferrand, Clermont-Ferrand, France.
Abstract
BACKGROUND: Indomethacin (IMC) as a prophylactic treatment is considered to be ineffective in cluster headache (CH). However, small series suggested the interest of IMC in CH. Some authors support that an IMC test is useful in all trigeminal autonomic cephalalgias. We described clinical features of IMC responders in a retrospective cohort of chronic cluster headache (CCH). METHODS: This single-center and retrospective study was conducted in a tertiary care specialist headache center in France. Patients were selected between January 2007 and December 2008. We included all patients fulfilling CCH criteria (ICHD-3-beta). Data were collected from medical records. We recorded all the prescriptions of IMC as a prophylactic treatment. Responders were defined by 50% reduction in attack frequency; complete response was defined by disappearance of the attacks. The non-responders must have received at least 100 mg daily during 7 days. RESULTS: The study consisted of 324 CCH, 121 female (37%) and 203 males (63%) with an average age at onset of 33.93 (± 14.71) years. Of the patients, 105 were treated with IMC. Thirty patients (29%) were responders. Thirty-four patients (32%) were non-responders. Responding status was undefined for 41 patients (39%). Twelve patients (11%) had a complete response. Responders were composed by 18 women (60%) and 12 men (40%) and had on average 44.89 (± 12.88) years. The minimal effective dose was 86.11 mg daily (± 48.72). DISCUSSION: This study shows the interest of IMC in CCH patients. We recommend an IMC test as a third-line treatment in CCH.
BACKGROUND:Indomethacin (IMC) as a prophylactic treatment is considered to be ineffective in cluster headache (CH). However, small series suggested the interest of IMC in CH. Some authors support that an IMC test is useful in all trigeminal autonomic cephalalgias. We described clinical features of IMC responders in a retrospective cohort of chronic cluster headache (CCH). METHODS: This single-center and retrospective study was conducted in a tertiary care specialist headache center in France. Patients were selected between January 2007 and December 2008. We included all patients fulfilling CCH criteria (ICHD-3-beta). Data were collected from medical records. We recorded all the prescriptions of IMC as a prophylactic treatment. Responders were defined by 50% reduction in attack frequency; complete response was defined by disappearance of the attacks. The non-responders must have received at least 100 mg daily during 7 days. RESULTS: The study consisted of 324 CCH, 121 female (37%) and 203 males (63%) with an average age at onset of 33.93 (± 14.71) years. Of the patients, 105 were treated with IMC. Thirty patients (29%) were responders. Thirty-four patients (32%) were non-responders. Responding status was undefined for 41 patients (39%). Twelve patients (11%) had a complete response. Responders were composed by 18 women (60%) and 12 men (40%) and had on average 44.89 (± 12.88) years. The minimal effective dose was 86.11 mg daily (± 48.72). DISCUSSION: This study shows the interest of IMC in CCH patients. We recommend an IMC test as a third-line treatment in CCH.
Authors: A Donnet; M Lanteri-Minet; E Guegan-Massardier; G Mick; N Fabre; G Géraud; C Lucas; M Navez; D Valade Journal: J Neurol Neurosurg Psychiatry Date: 2007-04-18 Impact factor: 10.154
Authors: Robert H Dworkin; Dennis C Turk; Kathleen W Wyrwich; Dorcas Beaton; Charles S Cleeland; John T Farrar; Jennifer A Haythornthwaite; Mark P Jensen; Robert D Kerns; Deborah N Ader; Nancy Brandenburg; Laurie B Burke; David Cella; Julie Chandler; Penny Cowan; Rozalina Dimitrova; Raymond Dionne; Sharon Hertz; Alejandro R Jadad; Nathaniel P Katz; Henrik Kehlet; Lynn D Kramer; Donald C Manning; Cynthia McCormick; Michael P McDermott; Henry J McQuay; Sanjay Patel; Linda Porter; Steve Quessy; Bob A Rappaport; Christine Rauschkolb; Dennis A Revicki; Margaret Rothman; Kenneth E Schmader; Brett R Stacey; Joseph W Stauffer; Thorsten von Stein; Richard E White; James Witter; Stojan Zavisic Journal: J Pain Date: 2007-12-11 Impact factor: 5.820