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Evolving options for the treatment of cluster headache
Maria Dolores Villar-Martinez1,2, Calvin Chan1,2, Peter J Goadsby1,2
1Department of Basic and Clinical Neuroscience, Institute of Psychology, Psychiatry and Neuroscience, King's College London.
Current Opinion in Neurology
|March 27, 2020
Summary
New treatments for cluster headache, a severe neurological disorder, include CGRP monoclonal antibodies and neuromodulation, offering better tolerability and effectiveness in reducing attacks.
Area of Science:
- Neurology
- Pain Medicine
Background:
- Cluster headache is recognized as one of the most severe pain conditions experienced by patients.
- Current management strategies are evolving with a growing understanding of the disorder's pathophysiology.
Purpose of the Study:
- To review and highlight recent advancements in the treatment of cluster headache.
- To discuss novel therapeutic targets and their clinical implications.
Main Methods:
- Review of recent clinical findings and research on cluster headache treatments.
- Focus on targeted therapies such as calcitonin gene-related peptide (CGRP) pathway blockade and neuromodulation.
Main Results:
- Calcitonin gene-related peptide (CGRP) monoclonal antibodies, like galcanezumab, show efficacy in reducing attack frequency for episodic cluster headache.
- Neuromodulation techniques targeting the sphenopalatine ganglion and vagus nerve are effective and well-tolerated for pain reduction and attack frequency.
- These novel treatments offer improved tolerability compared to classic therapies.
Conclusions:
- Novel treatments including CGRP monoclonal antibodies and neuromodulation represent significant advances in cluster headache management.
- Challenges remain in treating chronic cluster headache and in designing appropriate sham controls for device evaluation studies.
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