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Subcutaneous octreotide in cluster headache: randomized placebo-controlled double-blind crossover study
Manjit S Matharu1, Miles J Levy, Karim Meeran
1Headache Group, Institute of Neurology, Queen Square, London, United Kingdom.
Annals of Neurology
|September 30, 2004
Summary
Subcutaneous octreotide effectively treats acute cluster headache attacks. This non-vasoconstrictor treatment offers a new option for patients experiencing severe cluster headache pain.
Area of Science:
- Neurology
- Pharmacology
Background:
- Acute cluster headache treatments are limited, primarily involving sumatriptan and oxygen.
- Previous studies indicated potential efficacy of somatostatin for cluster headache.
- Octreotide, a somatostatin analog, has not been extensively studied for acute cluster headache.
Purpose of the Study:
- To evaluate the efficacy of subcutaneous octreotide as an abortive treatment for acute cluster headache.
- To compare octreotide's effectiveness against a placebo in a double-blind, randomized controlled trial.
Main Methods:
- A double-blind, placebo-controlled, crossover study involving 57 patients with episodic or chronic cluster headache.
- Patients self-administered subcutaneous octreotide (100 mcg) or placebo for two separate moderate-to-severe attacks.
- Headache response at 30 minutes was the primary endpoint, analyzed using multilevel modeling.
Main Results:
- The headache response rate was 52% with subcutaneous octreotide compared to 36% with placebo.
- Octreotide 100 mcg demonstrated a statistically significant superiority over placebo (p < 0.01).
- The treatment effect remained significant when considering patient-level variables and period effects.
Conclusions:
- Subcutaneous octreotide 100 mcg is an effective treatment for acute cluster headache.
- This study demonstrates the possibility of non-vasoconstrictor acute cluster headache treatment.
- Octreotide offers a promising alternative for managing acute cluster headache attacks.