Clinical Characteristics and Patient Burden of Cluster Headache in Brazil: A Real-World Study

Cluster headache (CH) is a debilitating condition with health-related and economic burden to patients, including reduced quality of life (QoL) and suicidality. Brazilian data on comorbidities, symptoms, or impact on QoL and productivity remain limited. This study aims to assess CH's impact on patients' QoL, overall health, and employment in Brazil from physicians' and patients' perspectives.

Data were extracted from the Adelphi Real World CH Disease Specific Programme™, a real-world, cross-sectional survey of physicians and their patients with CH in Brazil from November 2021-July 2022. Physicians reported on demographics, clinical characteristics, comorbidities, and suicidality. Patients reported CH's impact on feelings/reactions, suicidality, employment using the Work Productivity and Activity Impairment questionnaire, and QoL using the EuroQol 5 Dimension 5 Level survey. Data analyses were conducted with R Statistical software (v4.1.2).

Patients completed 177 forms, while physicians completed 450 forms. Patients had episodic CH (ECH, n = 355) and chronic CH (CCH, n = 95). Common comorbidities were anxiety, insomnia, hypertension, depression, and dyslipidemia. Stress and lack of sleep were key physician-reported CH triggers, and 10.34% of patients had considered suicide. The presence of CH may have led to absenteeism (11.45%) and presenteeism (30.08% overall work impairment, 29.38% activity impairment, and 29.36% impairment while working).

CH carries a significant disease burden and negative socioeconomic impact, especially among patients with CCH. Stress was the most common trigger for both attacks and bouts with notable rates of suicidality. This indicates a need among physicians and patients for targeted and more efficacious interventions to reduce CH's burden, improving patients' QoL.