Acceptability of Placebo in Cluster Headache Trials: A Patient Survey

This was an observational survey study administered to individuals over age 18 who identify themselves as having cluster headache. Patient perspectives on the use of placebo in cluster headache clinical trials were assessed using a paper-based survey. Participants were recruited during a national conference held for patients with cluster headaches (“Clusterbusters” in Austin, TX, September 2016). Informed consent was obtained and no identifiable data were collected.

Clinical Characteristics and Treatment Patterns among Patients with Diagnostic Codes for Cluster Headache in U.S. Healthcare Claims Data

This retrospective observational study analyzed claims data from the Truven Health Analytics MarketScan® Research Databases from 2009–2014. Two cohorts were compared: propensity-score (PS) matched CH and non-headache control patients. Eligible CH patients had ≥2 CH claims. All patients had continuous enrollment for ±12 months from date of first CH claim. Descriptive comparisons are presented.

Clinical Features of Cluster Headache Patients in Korea

Cluster headache (CH) is a rare underdiagnosed primary headache disorder with very severe unilateral pain and autonomic symptoms. Clinical characteristics of Korean patients with CH have not yet been reported. We analyzed the clinical features of CH patients from 11 university hospitals in Korea. Among a total of 200 patients with CH, only 1 patient had chronic CH. The average age of CH patients was 38.1 ± 8.9 years (range 19–60 years) and the average age of onset was 30.7 ± 10.3 years (range 10–57 years). The male-to-female ratio was 7:1 (2.9:1 among teen-onset and 11.7:1 among twenties-onset). Pain was very severe at 9.3 ± 1.0 on the visual analogue scale. The average duration of each attack was 100.6 ± 55.6 minutes and a bout of CH lasted 6.5 ± 4.5 weeks. Autonomic symptoms were present in 93.5% and restlessness or agitation was present in 43.5% of patients. Patients suffered 3.0 ± 3.5 (range 1–25) bouts over 7.3 ± 6.7 (range 1–30) years. Diurnal periodicity and season propensity were present in 68.5% and 44.0% of patients, respectively. There were no sex differences in associated symptoms or diurnal and seasonal periodicity. Korean CH patients had a high male-to-female ratio, relatively short bout duration, and low proportion of chronic CH, unlike CH patients in Western countries.

Global Incidence and Prevalence of Cluster Headache

We present a study of the general-population prevalence of cluster headache in the Republic of Georgia and discuss the advantages and challenges of different methodological approaches. In a community-based survey, specially trained medical residents visited 500 adjacent households in the capital city, Tbilisi, and 300 households in the eastern rural area of Kakheti.

Treatment of Cluster Headache in Pregnancy and Lactation

Cluster headache is a rare disorder in women, but has a serious impact on the affected woman’s life, especially on family planning. Women with cluster headache who are pregnant need special support, including the expertise of an experienced headache centre, an experienced gynecologist and possibly a teratology information centre. The patient should be seen through all stages of the pregnancy. A detailed briefing about the risks and safety of various treatment options is mandatory. In general, both the number of medications and the dosage should be kept as low as possible.