• Eur. J. Neurol. · Aug 2018

    Randomized Controlled Trial Multicenter Study

    Early management of patients with medication-overuse headache: results from a multicentre clinical study.

    • I Corbelli, P Sarchielli, P Eusebi, L M Cupini, S Caproni, P Calabresi, and SAMOHA Study Group.
    • Dipartimento di Medicina, Clinica Neurologica, Azienda Ospedaliero - Universitaria di Perugia, Perugia, Italy.
    • Eur. J. Neurol. 2018 Aug 1; 25 (8): 1027-1033.

    Background And PurposeEducational intervention has proved to be effective in reducing drug abuse in uncomplicated medication-overuse headache (MOH). This ancillary of the SAMOHA multicentre study aimed to assess any differences in phenotypic characteristics, type and amount of drugs overused, and comorbidities between patients with MOH who responded to simple advice and those who did not.MethodsDemographic and clinical headache data of the last 3 months before enrollment of patients were collected and patients were then asked to fill out a daily headache diary for 4 weeks. Patients were then divided into two subgroups, i.e. those with confirmed MOH continued in the study [randomized (R) group], whereas those who did not still show any features of MOH dropped out of the study.ResultsA total of 88 (67.7%) patients still met the inclusion criteria after the baseline 4 weeks (R group). Conversely, 42 (32.3%) patients dropped out of the study. A detailed analysis of those who dropped out revealed that only 34 were not randomized at visit 2 because they no longer satisfied the inclusion criteria for MOH [screening failures (SF) group]. The SF group was significantly younger and had fewer years of migraine history than the R group. Moreover, the SF group had a significantly shorter history of chronicity compared with the R group.ConclusionsOur findings suggest that in MOH trials, after an educational session, an observational period is needed in order to confirm the diagnosis of MOH and to avoid overestimation of the effect of other treatments used to manage MOH. Future research should focus mainly on those patients with MOH who do not respond to simple advice and with unsuccessful withdrawal.© 2018 EAN.

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