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Clusterkopfschmerzen – Bewährtes und Neues

Therapiestudien kritisch bewertet

Cluster headaches—proven and novel approaches

A critical evaluation of treatment studies

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Zusammenfassung

Trigeminoautonome Kopfschmerzerkrankungen sind durch einseitige Kopfschmerzen mit kranialen autonomen Symptomen und Bewegungsunruhe gekennzeichnet. Klinische Studien wurden in den vergangenen Jahren zur Akuttherapie und Prophylaxe des Clusterkopfschmerzes durchgeführt, die anderen trigeminoautonomen Kopfschmerzerkrankungen sind so selten, dass klinische Studien kaum durchführbar sind. Neu sind Daten zur Behandlung des episodischen Clusterkopfschmerzes mit Prednisolon, Galcanezumab und Fremanezumab sowie zur nichtinvasiven Vagusnervstimulation. Methodische Probleme ergeben sich bei der Patientenrekrutierung, den klinischen Endpunkten und aus dem möglichen pathophysiologischen Unterschied zwischen episodischem und chronischem Clusterkopfschmerz.

Abstract

Trigeminal autonomic cephalalgias are characterized by unilateral headaches accompanied by cranial autonomic symptoms and a sense of restlessness. Clinical trials have been conducted on acute therapy and prophylaxis of cluster headache in recent years. Since the other trigeminal autonomic cephalalgias are rare, it is virtually impossible to conduct controlled clinical trials for their investigation. Recent trials provide data on the efficacy of prednisolone, galcanezumab, fremanzeumab and noninvasive vagal nerve stimulation. Methodological difficulties arise in terms of patient recruitment for clinical trials, clinical endpoints and potential differences in the pathophysiology of episodic and chronic cluster headache.

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Authors and Affiliations

  1. Migräne- und Kopfschmerzklinik Königstein, Ölmühlweg 31, 61462, Königstein im Taunus, Deutschland

    Charly Gaul

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  1. Charly Gaul
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Correspondence to Charly Gaul.

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Interessenkonflikt

C. Gaul erhielt Referentenhonorare oder Beratungshonorare von Allergan Pharma, TEVA-Ratiopharm, (Ingelheim Pharma), Lilly, Novartis Pharma, Hormosan Pharma, Reckitt Benckiser, Weber & Weber und Grünenthal. C. Gaul besitzt keine Aktien oder Anteile pharmazeutischer Unternehmen.

Für diesen Beitrag wurden vom Autor keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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Gaul, C. Clusterkopfschmerzen – Bewährtes und Neues. Schmerz 34, 511–516 (2020). https://doi.org/10.1007/s00482-020-00512-7

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  • DOI: https://doi.org/10.1007/s00482-020-00512-7

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