Cluster headache and galcanezumab: the first real-world Brazilian study and an expert consensus on its use among other treatments
Abstract Objective To present the first Brazilian real-world results with galcanezumab and provide a consensus expert opinion on the prophylactic treatment of cluster headache (CH) in Brazil. Methods The first part of the study (real-world results) was observational, prospective, uncontrolled, and d...
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BMC
2024-12-01
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| Series: | The Journal of Headache and Pain |
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| Online Access: | https://doi.org/10.1186/s10194-024-01909-w |
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| author | Abouch Krymchantowski Carla Jevoux Élcio Juliato Piovesan Marcelo Moraes Valença Fernando Kowacs Pedro André Kowacs Fabíola Dach Paulo Hélio Monzillo Carlos Alberto Bordini Raimundo Pereira Silva-Néto |
| author_facet | Abouch Krymchantowski Carla Jevoux Élcio Juliato Piovesan Marcelo Moraes Valença Fernando Kowacs Pedro André Kowacs Fabíola Dach Paulo Hélio Monzillo Carlos Alberto Bordini Raimundo Pereira Silva-Néto |
| author_sort | Abouch Krymchantowski |
| collection | DOAJ |
| description | Abstract Objective To present the first Brazilian real-world results with galcanezumab and provide a consensus expert opinion on the prophylactic treatment of cluster headache (CH) in Brazil. Methods The first part of the study (real-world results) was observational, prospective, uncontrolled, and descriptive. A sample of 44 consecutive patients with episodic or chronic CH were evaluated and treated in a traditional tertiary clinic from March 2020 to June 2024. The second part (consensus expert opinion) consisted of a survey completed by ten Brazilian headache clinicians with at least 25 years of clinical experience, who published at least 15 headache papers and attended at least 15 national or international headache conferences. Results Forty-four patients (86.4% men, 13.6% women) were included. The average age was 45.9 ± 14.2 years. The diagnosis was made 27.3 ± 13.6 years after the onset of headache bouts. In 84.1% of the patients, CH was classified as episodic. Verapamil, lithium, or verapamil plus lithium were prescribed to respectively, 25%, 9.1%, and 6.8% of patients. Galcanezumab was prescribed to all and the majority (65.9%) used a dose of 300 mg once. There was a reduction in headache frequency of ≥ 50% at 3 weeks in 65.9% of patients for all doses of galcanezumab, and in 72.4% of those using galcanezumab 300 mg. Verapamil was recommended as a first-line treatment by 6 of 10 experts and a second-line treatment by the other 4 experts; galcanezumab was recommended as a first-line treatment by 4 of 10 experts and as a second-line treatment by 3 of 10 experts. Conclusions This study presented the first real-world data with galcanezumab in Brazilian patients with CH and showed a reduction in headache frequency in most patients. A survey of Brazilian experts not meant to represent the country’s guidelines, favored galcanezumab as either the first or the second option in prophylaxis. Collectively, these results highlighted galcanezumab’s promising efficacy as a new tool in CH patients. |
| format | Article |
| id | doaj-art-e47d4f7e08894e3da5d04995026d46e0 |
| institution | OA Journals |
| issn | 1129-2377 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | BMC |
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| series | The Journal of Headache and Pain |
| spelling | doaj-art-e47d4f7e08894e3da5d04995026d46e02025-08-20T02:30:54ZengBMCThe Journal of Headache and Pain1129-23772024-12-012511810.1186/s10194-024-01909-wCluster headache and galcanezumab: the first real-world Brazilian study and an expert consensus on its use among other treatmentsAbouch Krymchantowski0Carla Jevoux1Élcio Juliato Piovesan2Marcelo Moraes Valença3Fernando Kowacs4Pedro André Kowacs5Fabíola Dach6Paulo Hélio Monzillo7Carlos Alberto Bordini8Raimundo Pereira Silva-Néto9Headache Center of RioHeadache Center of RioUniversidade Federal do ParanáUniversidade Federal de PernambucoHospital Moinhos de VentoUniversidade Federal do ParanáUniversidade de São PauloHospital Israelita Albert EinsteinClínica de Cefaleias de BatataisUniversidade Federal do Delta do ParnaíbaAbstract Objective To present the first Brazilian real-world results with galcanezumab and provide a consensus expert opinion on the prophylactic treatment of cluster headache (CH) in Brazil. Methods The first part of the study (real-world results) was observational, prospective, uncontrolled, and descriptive. A sample of 44 consecutive patients with episodic or chronic CH were evaluated and treated in a traditional tertiary clinic from March 2020 to June 2024. The second part (consensus expert opinion) consisted of a survey completed by ten Brazilian headache clinicians with at least 25 years of clinical experience, who published at least 15 headache papers and attended at least 15 national or international headache conferences. Results Forty-four patients (86.4% men, 13.6% women) were included. The average age was 45.9 ± 14.2 years. The diagnosis was made 27.3 ± 13.6 years after the onset of headache bouts. In 84.1% of the patients, CH was classified as episodic. Verapamil, lithium, or verapamil plus lithium were prescribed to respectively, 25%, 9.1%, and 6.8% of patients. Galcanezumab was prescribed to all and the majority (65.9%) used a dose of 300 mg once. There was a reduction in headache frequency of ≥ 50% at 3 weeks in 65.9% of patients for all doses of galcanezumab, and in 72.4% of those using galcanezumab 300 mg. Verapamil was recommended as a first-line treatment by 6 of 10 experts and a second-line treatment by the other 4 experts; galcanezumab was recommended as a first-line treatment by 4 of 10 experts and as a second-line treatment by 3 of 10 experts. Conclusions This study presented the first real-world data with galcanezumab in Brazilian patients with CH and showed a reduction in headache frequency in most patients. A survey of Brazilian experts not meant to represent the country’s guidelines, favored galcanezumab as either the first or the second option in prophylaxis. Collectively, these results highlighted galcanezumab’s promising efficacy as a new tool in CH patients.https://doi.org/10.1186/s10194-024-01909-wCluster headacheTreatmentGalcanezumabExpert consensusBrazil |
| spellingShingle | Abouch Krymchantowski Carla Jevoux Élcio Juliato Piovesan Marcelo Moraes Valença Fernando Kowacs Pedro André Kowacs Fabíola Dach Paulo Hélio Monzillo Carlos Alberto Bordini Raimundo Pereira Silva-Néto Cluster headache and galcanezumab: the first real-world Brazilian study and an expert consensus on its use among other treatments The Journal of Headache and Pain Cluster headache Treatment Galcanezumab Expert consensus Brazil |
| title | Cluster headache and galcanezumab: the first real-world Brazilian study and an expert consensus on its use among other treatments |
| title_full | Cluster headache and galcanezumab: the first real-world Brazilian study and an expert consensus on its use among other treatments |
| title_fullStr | Cluster headache and galcanezumab: the first real-world Brazilian study and an expert consensus on its use among other treatments |
| title_full_unstemmed | Cluster headache and galcanezumab: the first real-world Brazilian study and an expert consensus on its use among other treatments |
| title_short | Cluster headache and galcanezumab: the first real-world Brazilian study and an expert consensus on its use among other treatments |
| title_sort | cluster headache and galcanezumab the first real world brazilian study and an expert consensus on its use among other treatments |
| topic | Cluster headache Treatment Galcanezumab Expert consensus Brazil |
| url | https://doi.org/10.1186/s10194-024-01909-w |
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