Medication overuse headache: a critical review of end points in recent follow-up studies

TY - JOUR

T1 - Medication overuse headache: a critical review of end points in recent follow-up studies

AU - Hagen, Knut

AU - Jensen, Rigmor

AU - Bøe, Magne Geir

AU - Stovner, Lars Jacob

PY - 2010/10/1

Y1 - 2010/10/1

N2 - No guidelines for performing and presenting the results of studies on patients with medication overuse headache (MOH) exist. The aim of this study was to review long-term outcome measures in follow-up studies published in 2006 or later. We included MOH studies with >6 months duration presenting a minimum of one predefined end point. In total, nine studies were identified. The 1,589 MOH patients (22% men) had an overall mean frequency of 25.3 headache days/month at baseline. Headache days/month at the end of follow-up was reported in six studies (mean 13.8 days/month). The decrease was more pronounced for studies including patients with migraine only (-14.6 days/month) compared to studies with the original diagnoses of migraine and tension-type headache (-9.2 days/month). Six studies reported relapse rate (mean of 26%) and/or responder rate (mean of 28%). Medication days/month and change in headache index at the end of follow-up were reported in only one and two of nine studies, respectively. The present review demonstrated a lack of uniform end points used in recently published follow-up studies. Guidelines for presenting follow-up data on MOH are needed and we propose end points such as headache days/month, medication days/month, relapse rate and responder rate defined as =50% reduction of headache frequency and/or headache index from baseline.

AB - No guidelines for performing and presenting the results of studies on patients with medication overuse headache (MOH) exist. The aim of this study was to review long-term outcome measures in follow-up studies published in 2006 or later. We included MOH studies with >6 months duration presenting a minimum of one predefined end point. In total, nine studies were identified. The 1,589 MOH patients (22% men) had an overall mean frequency of 25.3 headache days/month at baseline. Headache days/month at the end of follow-up was reported in six studies (mean 13.8 days/month). The decrease was more pronounced for studies including patients with migraine only (-14.6 days/month) compared to studies with the original diagnoses of migraine and tension-type headache (-9.2 days/month). Six studies reported relapse rate (mean of 26%) and/or responder rate (mean of 28%). Medication days/month and change in headache index at the end of follow-up were reported in only one and two of nine studies, respectively. The present review demonstrated a lack of uniform end points used in recently published follow-up studies. Guidelines for presenting follow-up data on MOH are needed and we propose end points such as headache days/month, medication days/month, relapse rate and responder rate defined as =50% reduction of headache frequency and/or headache index from baseline.

U2 - http://dx.doi.org/10.1007/s10194-010-0221-4

DO - http://dx.doi.org/10.1007/s10194-010-0221-4

M3 - Journal article

SN - 1129-2369

VL - 11

SP - 373

EP - 377

JO - Journal of Headache and Pain

JF - Journal of Headache and Pain

IS - 5

ER -